Transurethral Holmium Laser Enucleation Versus Transvesical Open Enucleation for Prostate Adenoma Greater Than 100 gm.: A Randomized Prospective Trial of 120 Patients

Kuntz, Rainer M.; Lehrich, Karin

doi:10.1097/00005392-200210010-00039

Cited by 106 publications

(143 citation statements)

References 15 publications

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“…These results were derived from a plateau curve of tissue enucleation efficacy. We found that reports based on subjective experience or confidence concluded that HoLEP competency required 20-30 cases of experience (6,11). On the other hand, reports based on enucleation efficacy concluded that at least 50 cases were needed to attain competency (12,13).…”

Section: Discussionmentioning

confidence: 79%

“…Compared to TURP or open prostatectomy, HoLEP has similar clinical outcome, lower postoperative complication rate and requires shorter hospital stay (4)(5)(6)(7)(8). In addition, HoLEP appears to be a true endourological alternative to open prostatectomy, because it can effectively treat a very large prostate (9,10).…”

Section: Original Article Introductionmentioning

confidence: 99%

“…Some researchers have argued that a surgeon needs between 20 and 30 cases of experience to attain competency (6,11), while others have argued that up to 50 cases are needed (12,13). This discrepancy comes mainly from the absence of an accurate way to evaluate the operative learning curve.…”

Section: Original Article Introductionmentioning

confidence: 99%

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Enucleation ratio efficacy might be a better predictor to assess learning curve of holmium laser enucleation of the prostate

Jeong

Cho

et al. 2012

Int. braz j urol.

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Section: Discussionmentioning

confidence: 79%

Section: Original Article Introductionmentioning

confidence: 99%

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Enucleation ratio efficacy might be a better predictor to assess learning curve of holmium laser enucleation of the prostate

Jeong

Cho

et al. 2012

Int. braz j urol.

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“…Several randomized controlled trials have clarified that HoLEP is superior to TURP [10][11][12][13] and open prostatectomy. [14][15][16] Other reports have documented that HoLEP is as durable as open prostatectomy at more than 5-year follow-up. 8,14,17 Furthermore, HoLEP has shown that efficacy and safety are independent of prostate size under about 100 or more performances.…”

Section: Discussionmentioning

confidence: 99%

The relationship between the reproducibility of holmium laser enucleation of the prostate and prostate size over the learning curve

Haraguchi

Takenaka

Yamazaki

et al. 2009

Prostate Cancer Prostatic Dis

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The purpose of this study was to analyze the relationship between the reproducibility of holmium laser enucleation of the prostate (HoLEP) and prostate size over the learning curve. We compared the outcome among three institutions in three subgroups on the basis of the weight of tissue retrieved. There were no significant differences in operating time, efficiency of the procedure, decrease in hemoglobin level and postoperative urinary incontinence among three institutions, only in patients with prostates X20 g-o40 g retrieved. Our data indicate that HoLEP is more reproducible in patients with a moderate-sized prostate over the learning curve.

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“…The laser simultaneously vaporizes the tissue and stops the bleeding from minor to medium sized vessels [22][23][24] . Thus, the overall incidence of cases necessitating transfusion is minuscule even for procedures in large-sized prostates 25) .…”

Section: Discussionmentioning

confidence: 99%

Outcomes of the Holmium Laser Enucleation of the Prostate for Patients With Prior Benign Prostatic Hyperplasia Surgery

Moon

Kim

Yoon

et al. 2014

J Korean Geriatr Soc

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Background:To assess the functional outcomes and morbidity in patients undergoing holmium laser enucleation of the prostate (HoLEP) with and without previous transurethral prostate surgery. Methods: Patients were stratified into two groups, 558 patients who underwent primary HoLEP (group I) and 50 patients who underwent 'secondary-HoLEP' with prior transurethral prostate surgery (group II). Results: There were no significant differences in the preoperative parameters (median age, International Prostate Symptom Score [IPSS], prostate-specific antigen [PSA], prostate volume, maximum urinary flow rate [Qmax], and postvoid residual urine volume [PVR]). No significant intraoperative differences were noted in the use of total energy, resected volume, enucleation time, resection efficiency, and mean catheterization time. There were significant improvements in Qmax, PVR, and IPSS in both groups. Complications in groups I and II included 19 (3.1%) and 1 (2.0%) bladder injuries, 25 (4.4%) and 2 (4.0%) recatheterization for transient voiding difficulty, 20 (3.5%) and 2 (4%) cases of severe hematuria requiring additional treatment, and 5 (0.8%) and 0 cases for remorcellation due to remaining adenoma. Transient incontinence was the most common complication for both groups I and II, 30 cases (5.4%) and 3 cases (6.0%) respectively. Urinary tract infection showed improvement subsequent to antibiotic treatment. During the 6 month follow-up period, urethral stricture occurred in 7 cases (1.3%) for group I and in 1 case (2.0%) for group II. Conclusion: There were no significant differences in functional outcomes and morbidity between the two groups. 'Secondary-HoLEP' seems to be effective and safe for patients with prior BPH surgery.

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Transurethral Holmium Laser Enucleation Versus Transvesical Open Enucleation for Prostate Adenoma Greater Than 100 gm.: A Randomized Prospective Trial of 120 Patients

Abstract: Holmium laser enucleation of the prostate and open prostatectomy are equally effective procedures for removal of large prostatic adenomas. Holmium laser enucleation resulted in significantly less perioperative morbidity and may become the endourological alternative to open prostatectomy.

Cited by 106 publications

References 15 publications

Enucleation ratio efficacy might be a better predictor to assess learning curve of holmium laser enucleation of the prostate

Enucleation ratio efficacy might be a better predictor to assess learning curve of holmium laser enucleation of the prostate

The relationship between the reproducibility of holmium laser enucleation of the prostate and prostate size over the learning curve

Outcomes of the Holmium Laser Enucleation of the Prostate for Patients With Prior Benign Prostatic Hyperplasia Surgery

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