Trends and Perioperative Outcomes Across Major Benign Prostatic Hyperplasia Procedures from the ACS-NSQIP 2011–2015

Anderson, Blake; Heiman, Joshua; Large, Tim; Lingeman, James E.; Krambeck, Amy E.

doi:10.1089/end.2018.0266

Cited by 52 publications

(19 citation statements)

References 25 publications

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“…HoLEP has traditionally required a postoperative hospital stay to manage hematuria with continuous bladder irrigation (CBI) [7], with transfusion rates of 4% [8]. However, HoLEP has superior blood transfusion rates, catheterization times, and hospital stays compared to transurethral resection of the prostate (TURP) and open simple prostatectomy (OP) [7,9,10]. Advances in operative techniques [11] have improved the efficiency of HoLEP and advances in laser technologies have improved hemostasis [12].…”

Section: Introductionmentioning

confidence: 99%

Same Day Discharge is a Successful Approach for the Majority of Patients Undergoing Holmium Laser Enucleation of the Prostate

Agarwal

Large

Tong

et al. 2022

European Urology Focus

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Section: Introductionmentioning

confidence: 99%

Same Day Discharge is a Successful Approach for the Majority of Patients Undergoing Holmium Laser Enucleation of the Prostate

Agarwal

Large

Tong

et al. 2022

European Urology Focus

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“…TURP, photovaporization of the prostate (PVP) and HoLEP are all traditionally associated with at least overnight hospital stays. 3 , 4 Newer technologies such as bipolar TURP and 180W PVP have allowed those procedures to be more conducive to same day discharge. In an attempt to reduce morbidity of BPH treatment, new therapies have emerged, such as convective water thermal therapy and prostatic urethral lift, 5 with the goal of same day procedure discharge, minimal morbidity and reduced duration of indwelling catheter dwell time.…”

Section: Introductionmentioning

confidence: 99%

Catheter Removal on the Same Day of Holmium Laser Enucleation of the Prostate: Outcomes of a Pilot Study

Agarwal

Rivera

Nottingham

et al. 2020

Urology

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Objectives To determine if same day catheter removal is feasible in select population after holmium laser enucleation of the prostate (HoLEP). Methods We performed an analysis of patients undergoing HoLEP at our institution who underwent same-day catheter removal after HoLEP. All HoLEPs were performed with Moses Optimized for BPH. Patients were dismissed from postoperative recovery unit (POCU) to the clinic for catheter removal and voiding trial. Results To date, 30 patients have undergone same day catheter removal. Median age is 68.6 years (IQR 61.8-73.3) and preoperative prostate volume 81 ml (IQR 53-114.8). Median enucleation time was 39.5 min (IQR 30.5-53), morcellation time was 5 min (IQR 4-12 min) and enucleated specimen weight was 52.5 g (IQR 33-81). 27 (90%) patients successfully voided on the same day without requiring catheter replacement. All patients were catheter free by POD1. For patients who successfully passed their voiding trial, the median time from the end of the procedure to hospital discharge was 2.6 hours (IQR (2.1-2.9) and from the end of the HoLEP to catheter removal was 4.9 hours (IQR 3.5-6.0). Conclusions We present for the first time that same day catheter removal is a feasible option in a select population of patients undergoing HoLEP. With more study, this has the potential for transforming the management of BPH, especially larger glands.

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“…Thus, a gold‐standard technique must be efficient, safe, cost effective, and reproducible versus the current best choice of treatment. aEEP has not reached this status for several issues and that is the reason why, nowadays, EEP is seriously underused and, in the United States, represents only 5% of all BPH surgeries (Anderson, Heiman, Large, Lingeman, & Krambeck, 2019). Below, we detail the main reasons that may justify it (Figure 1).…”

Section: Introductionmentioning

confidence: 99%

Anatomical endoscopic enucleation of the prostate: The next gold standard? No! (or not yet!)

2020

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Most cases of lower urinary tract symptoms due to benign prostatic hyperplasia are initially managed through medical therapy. In cases that surgery is indicated, the anatomical endoscopic enucleation of the prostate (aEEP), first described in 1983, allegedly presents the same safety profile as the best endoscopic non-enucleating procedures and the same long-term functional outcomes as simple prostatectomy. Thus, why aEEP has not yet been consolidated as the gold-standard BPH surgical treatment? The main reasons are as follows: (a) Multiple energy sources and techniques; (b) High costs; (c) Steep learning curve; (d) Rare in-residency training; (e) Reimbursement issues; (f) Outcomes and (g) Complications. We do believe aEEP is an important advance and a "practice-changing" procedure that will play an important role in the BPH surgical options arsenal, especially for larger prostates. However, there is a need to start an in-residency training program, with a mentor guidance, and, over time, the cost will likely be reduced due to greater competition between companies and greater support from health insurers. Considering these points, in the future, EEP may be considered the gold-standard treatment for BPH… but not yet. K E Y W O R D S endoscopic surgical procedure, prostate, prostatic hyperplasia, standard of care, urologic surgical procedures How to cite this article: Wroclawski ML, Teles SB, Carneiro A. Anatomical endoscopic enucleation of the prostate: The next gold standard? No! (or not yet!). Andrologia.

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Trends and Perioperative Outcomes Across Major Benign Prostatic Hyperplasia Procedures from the ACS-NSQIP 2011–2015

Cited by 52 publications

References 25 publications

Same Day Discharge is a Successful Approach for the Majority of Patients Undergoing Holmium Laser Enucleation of the Prostate

Same Day Discharge is a Successful Approach for the Majority of Patients Undergoing Holmium Laser Enucleation of the Prostate

Catheter Removal on the Same Day of Holmium Laser Enucleation of the Prostate: Outcomes of a Pilot Study

Anatomical endoscopic enucleation of the prostate: The next gold standard? No! (or not yet!)

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