Randomized trial comparing holmium laser enucleation of prostate with plasmakinetic enucleation of prostate for treatment of benign prostatic hyperplasia

Neill, Mischel G.; Gilling, Peter; Kennett, Katie M.; Frampton, Christopher; Westenberg, Andre M.; Fraundorfer, Mark R.; Wilson, L.

doi:10.1016/j.urology.2006.06.021

Cited by 146 publications

(128 citation statements)

References 14 publications

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“…Similar to previous studies of TUERP, our patients showed a mean 90.1% reduction in PSA concentration and a mean 67.3% reduction in PV, from 65.4 to 21.4 cc [5,16], strongly suggesting that TUERP results in complete adenoma removal. We also found that 36 patients (2.6%) were diagnosed with prostate carcinoma after TUERP, a rate similar to the 3% of patients who underwent HoLEP [17].…”

Section: Discussionsupporting

confidence: 90%

Long-term Follow-up of Transurethral Enucleation Resection of the Prostate for Symptomatic Benign Prostatic Hyperplasia

Peng¹,

Zhihai²,

Jiao³

et al. 2016

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Abstract:Transurethral enucleation resection of the prostate is safe and feasible for the treatment of symptomatic benign prostatic hyperplasia (BPH). However, long-term results of this treatment in patients with BPH have not been reported. To assess the efficacy and safety of this procedure, this study retrospectively evaluated long-term outcomes in 1400 consecutive patients who underwent transurethral enucleation resection of the prostate for BPH between 2008 and 2014. Patients were followed up at 1, 3, 6, and 12 months, and every year thereafter. At a median follow-up of 70.1 months, mean Qmax increased from 6.43 to 22.1 ml/s and mean IPSS decreased from 22.3 to 2.9. PVR decreased from 123.0 to 12.0 cc, and mean TRUS volume decreased from 65.4 to 21.4 ml (P<0.0000). QOL score improved from 4.96 to 1.0, and PSA concentrations decreased from 6.87 to 0.75 ng/ml (P<0.0000). Complications included bladder neck contracture in 1.0% of patients and urethral stricture in 1.3%. These long-term results showed that transurethral enucleation resection of the prostate is durable, safe, and effective for patients with BPH, with patients not requiring reoperation.

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Section: Discussionsupporting

confidence: 90%

Long-term Follow-up of Transurethral Enucleation Resection of the Prostate for Symptomatic Benign Prostatic Hyperplasia

Peng¹,

Zhihai²,

Jiao³

et al. 2016

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“…Therefore, the bipolar enucleation using the PlasmaKinetic system (Gyrus Medical GmbH, Tuttlingen, Germany) was devised. According to the initial results of a randomized controlled trial comparing HoLEP and PlasmaKinetic enucleation of prostate, bipolar enucleation using the PlasmaKinetic system was as safe and effective as HoLEP [ 19 ] .…”

Section: T U E B a N D T R A N S U R E T H R A L R E S E C T I O N I mentioning

confidence: 99%

Comparison of transurethral enucleation with bipolar and transurethral resection in saline for managing benign prostatic hyperplasia

et al. 2012

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Study Type – Therapy (case series)Level of Evidence 4What's known on the subject? and What does the study add?Transurethral enucleation with bipolar (TUEB) has been widely adopted as an alternative to standard TURP, although the surgical technique, efficacy and safety of TUEB have not been described so far.The present study provides illustrations of the TUEB technique, as well as peri‐operative, 6‐month and 12‐month follow‐up results of TUEB from a retrospective review of a single‐institution experience comparing the efficacy and safety of TUEB and transurethral resection in saline for managing BPH.OBJECTIVE To illustrate the transurethral enucleation with bipolar (TUEB) technique and compare the efficacy and safety of TUEB and transurethral resection in saline (TURis) for managing benign prostatic hyperplasia (BPH). PATIENTS AND METHODS A retrospective review of a single‐institution experience of 110 consecutive TUEB or TURis between 2008 and 2011 at our hospital was performed aiming to compare the efficacy and safety of TUEB and TURis for managing BPH (55 patients in each group). Peri‐operative data included operating time, resected tissue weight, changes in haemoglobin, duration of catheterization, hospital stay and early complications. Postoperative outcomes included 6‐ and 12‐month postoperative International Prostate Symptom Score (IPSS), and Quality of Life (QoL) score, uroflowmetry findings, change in serum prostate‐specific antigen level and all late complications in the two groups. RESULTS Both groups were well matched for age, preoperative prostate volume, IPSS, QoL and uroflowmetry findings. The change in haemoglobin at postoperative day 1 in the TUEB group was significantly less than in the TURis group (1.08 vs 1.60 g/dL; P < 0.001). Catheterization time and hospital stay were significantly shorter in the TUEB group than in the TURis group and the mean retrieved tissue weight in the TUEB group was larger than that in the TURis group (41.3 vs 31.7 g; P= 0.007). Patients in the two arms had comparable improvements in postoperative IPSS, QoL, maximum flow rate and postvoid residual urine volume. The rates of complications were equally low with each procedure. CONCLUSION TUEB is superior to TURis, with less bleeding, as well as decreased catheter time and hospital stay, although showing equivalent efficacy at 12 months of follow‐up.

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“…followed in 2004 [2], then later in the end of the 2000s all other transurethral laser-based enucleation techniques: Tm:YAG Vapoenucleation (ThuVEP) [3], transurethral anatomical enucleation with Tm:YAG Support (ThuLEP) [4], diode laser enucleation of the prostate (DiLEP) [5] and finally Lithium-Borate "Greenlight" enucleation of the prostate (GreenLEP) [6] appeared on the market to finally replace open prostatectomy (OP) and TURP. It took Thulium:YAG as the challenger to initiate a discussion about the impact of laser in transurethral enucleation.…”

mentioning

confidence: 99%

Enucleation is enucleation is enucleation is enucleation

Herrmann

2016

World J Urol

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followed in 2004 [2], then later in the end of the 2000s all other transurethral laser-based enucleation techniques: Tm:YAG Vapoenucleation (ThuVEP) [3], transurethral anatomical enucleation with Tm:YAG Support (ThuLEP) [4], diode laser enucleation of the prostate (DiLEP) [5] and finally Lithium-Borate "Greenlight" enucleation of the prostate (GreenLEP) [6] appeared on the market to finally replace open prostatectomy (OP) and TURP. It took Thulium:YAG as the challenger to initiate a discussion about the impact of laser in transurethral enucleation. The surgical twins "ThuVEP" and "ThuLEP" demonstrated the whole spectrum of laser action in enucleating techniques. ThuVEP focuses on the favorable vaporization effect of continuous-wave lasers to perform a fast, effective and safe enucleation, whereas ThuLEP focuses on almost blunt mechanical enucleation using the laser only for dissection of adherences and mucosa. The latter on anatomy focusing approach was mimicked by other continuous-wave lasers (LBO/"Greenlight" and 980 nm diode laser) that had not been found suitable for enucleation at the initial point of the discussion [5,6].The most famous quotation from Gertrude Stein's poem Sacred Emily "Rose is a rose is a rose is a rose." is often interpreted as "things are what they are." When reviewing all meta-analyses and structured reviews of the past 3 years, the energy source seems to be secondary and a result of resources and personal preference of a skilled surgeon, today [7]. The time has come to move from sophistical marketing of a single energy source to the overarching principle of anatomical enucleation to focus all efforts to establish enucleation as the de facto standard treatment 32 years after Hiraoka [8] laid the cornerstone for all anatomical transurethral enucleation techniques of the prostate with his monopolar transurethral detachment prostatectomy technique (TUE). Abstract The latest update of the EAU Guidelines on Management of Non-Neurogenic Male Lower Urinary Tract Symptoms, incl. Benign Prostatic Obstruction in 2016 announced a novel acronym for transurethral Endoscopic Enucleation of the Prostate (EEP). This was inspired by a meta-analysis on randomized controlled trials on HolmiumLaser Enucleation of the Prostate (HolEP) and bipolar enucleation versus open simple prostatectomy. EEP codes for the common ground of both techniques: "anatomical enucleation." Although study quality with regard to the availability of long-term randomized controlled trials is at the moment mostly available for HoLEP, and bipolar enucleation, the existing data of all other enucleating techniques that have been demonstrated to perform anatomical enucleation as well should also been summarized under the same term. This editorial is a call for embracing this acronym of EEP for all anatomical enucleating techniques in order to serve for the transition from the age of TURP and open prostatectomy toward the age of EEP. Editorial,The great merit of holmium laser enucleation of the prostate (HoLEP) is to have laid out the re...

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Randomized trial comparing holmium laser enucleation of prostate with plasmakinetic enucleation of prostate for treatment of benign prostatic hyperplasia

Cited by 146 publications

References 14 publications

Long-term Follow-up of Transurethral Enucleation Resection of the Prostate for Symptomatic Benign Prostatic Hyperplasia

Long-term Follow-up of Transurethral Enucleation Resection of the Prostate for Symptomatic Benign Prostatic Hyperplasia

Comparison of transurethral enucleation with bipolar and transurethral resection in saline for managing benign prostatic hyperplasia

Enucleation is enucleation is enucleation is enucleation

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