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Benoit Peyronnet, Grégoire Robert, Vincent Comat, Morgan Rouprêt, Fernando Gomez-Sancha, Jean-Nicolas Cornu, Vincent Misrai
PURPOSE: To compare the learning curves, perioperative and early functional outcomes after HoLEP and GreenLEP. METHODS: Data from the first 100 consecutive cases treated by GreenLEP and HoLEP by two surgeons were prospectively collected from dedicated databases and analysed retrospectively. En-bloc GreenLEP and two-lobar HoLEP enucleations were conducted using the GreenLight HPS™ 2090 laser and Lumenis™ holmium laser. Patients' characteristics, perioperative outcomes and functional outcomes after 1, 3 and 6 months were compared between groups...
October 20, 2016: World Journal of Urology
Takayuki Sumiyoshi, Jin Kohno, Atsushi Maeno, Kazutoshi Okubo, Takeshi Takahashi, Kenji Mitsumori, Kazuo Nishimura
Holmium laser enucleation of the prostate (HoLEP) is a standard surgical procedure for treatment of benign prostatic hyperplasia (BPH). A low incidence of postoperative urinary incontinence in association with anteroposterior dissection HoLEP was recently reported. We evaluated 66 patients with BPH who underwent anteroposterior dissection HoLEP from March 2013 to November 2014. The International Prostate Symptom Score (IPSS), quality of life (QOL) index, maximum flow rate (Qmax), and post-void residual urine volume (PVR) were assessed preoperatively and at 1 and 3 months after treatment...
September 2016: Hinyokika Kiyo. Acta Urologica Japonica
Huan Xu, Chong Liu, Meng Gu, Yanbo Chen, Zhikang Cai, Qi Chen, Zhong Wang
PURPOSE: To evaluate the relationship between prostatic vessel changes induced by cigarette smoking and the perioperative outcome of holmium laser enucleation of the prostate (HoLEP). MATERIALS AND METHODS: A total of 268 postoperative patients with benign prostatic hyperplasia (BPH) were prospectively analysed in our department. They were divided into two groups (smokers and non-smokers) according to smoking history. Transrectal colour Doppler ultrasound was performed to evaluate the prostate vascular changes...
October 9, 2016: Oncotarget
Jung Kwon Kim, Min Chul Cho, Hwancheol Son, Ja Hyeon Ku, Seung-June Oh, Jae-Seung Paick
OBJECTIVES: To investigate patient perception of ejaculatory volume reduction after HoLEP. METHODS: A total of 192 patients were included in the analysis. All patients completed six self-developed, non-validated questionnaires. The questionnaires were composed of questions involving overall satisfaction, voiding symptom change, current experience of sexual intercourse, ejaculatory volume change, change of orgasmic intensity, and the patient's perception of postoperative ejaculatory volume reduction...
October 7, 2016: Urology
Sarah E Dodd, Christopher J Jankowski, Amy E Krambeck, Bhargavi Gali
Holmium laser enucleation of prostate (HoLEP) is being performed with increasing frequency as a minimally invasive alternative to transurethral resection of the prostate (TURP) for the surgical management of benign prostatic hyperplasia (BPH). HoLEP offers the advantage of use of normal saline for irrigation, instead of glycine which is utilized in TURP, decreasing the likelihood of fluid absorption and effects on serum electrolytes. We describe a patient who underwent HoLEP for BPH and subsequently developed non-ion gap metabolic acidosis and hemodilution associated with volume overload...
October 6, 2016: Journal of Anesthesia
T R W Herrmann
BACKGROUND: In the last 20 years various transurethral endoscopic enucleation techniques (EEP) have been established as a substitute for open prostatectomy (OP) and TURP. Since the 2016 update of the "EAU Guidelines on Management of Non-Neurogenic Male Lower Urinary Tract Symptoms (LUTS), including Benign Prostatic Obstruction (BPO)", Holmium laser enucleation of the prostate (HoLEP) and bipolar enucleation being summarized as anatomical enucleating techniques are proposed as first choice for the surgical management of BPO of large volume prostates...
October 6, 2016: Der Urologe. Ausg. A
Teerayut Tangpaitoon, Tracy Marien, Mustafa Kadihasanoglu, Nicole L Miller
OBJECTIVE: To compare the outcomes of men undergoing holmium laser enucleation of the prostate (HoLEP) with and without concurrent holmium laser cystolitholapaxy (HLC). METHODS: A retrospective review of a prospectively maintained database was performed on patients who underwent HoLEP: Group 1 (N = 279) and HoLEP with concurrent HLC: Group 2 (N = 41) between June 2008 and July 2015. Patient characteristics and outcomes were compared. RESULTS: The average bladder stone burden was 3...
September 13, 2016: Urology
Paolo Umari, Nicola Fossati, Giorgio Gandaglia, Morgan Pokorny, Ruben De Groote, Nicolas Geurts, Marijn Goossens, Peter Schatterman, Geert De Naeyer, Alexandre Mottrie
OBJECTIVE: To report a comparative analysis of Robotic-assisted Simple Prostatectomy (RASP) versus Holmium Laser Enucleation of Prostate (HoLEP) in Benign Prostatic Hyperplasia (BPH) patients with large volume prostates (>100ml). MATERIAL AND METHODS: 81 patients underwent RASP and 45 underwent HoLEP over a 7-year period. Patients were preoperatively assessed with transrectal ultrasound and uroflowmetry. Functional parameters were assessed postoperatively during the follow-up...
September 8, 2016: Journal of Urology
M Baron, F-X Nouhaud, C Delcourt, P Grise, C Pfister, J-N Cornu, L Sibert
AIM: Holmium laser enucleation of prostate (HoLEP) is renowned for the difficulty of its learning curve. Our aim was to evaluate the interest of a three-step tutorial in the HoLEP learning curve, in a university center. METHODS: It is a retrospective, monocentric study of the 82 first procedures done consecutively by the same operator with a proctoring in early experience and after 40 procedures. For all patients were noted: enucleation efficiency (g/min), morcellation efficiency (g/min), percentage of enucleated tissue (enucleated tissue/adenome weigth evaluated by ultrasonography...
September 2016: Progrès en Urologie
Akiko Fujisaki, Aya Goto, Fumiyasu Endo, Osamu Muraishi, Kazunori Hattori, Seiji Yasumura
INTRODUCTION: Epidemiological data regarding complications after holmium laser enucleation of the prostate (HoLEP) are scarce in Japan. We examined the associations of the 24-hour pad test results immediately after HoLEP with continence acquisition at 3 months postoperatively. MATERIALS AND METHODS: In this hospital-based case-series study, we reviewed medical charts of 341 patients without catheterization and 150 patients with catheterization at the time of surgery...
2016: Urologia Internationalis
Thomas R W Herrmann
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 Holmium Laser 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...
October 2016: World Journal of Urology
Esha L Gopee, Matthew K H Hong, Trung Pham
The modality of choice in the surgical management of benign prostatic hyperplasia for large prostates has traditionally been open prostatectomy. Advances in minimally invasive techniques have begun to challenge this notion with advantages such as lower bleeding and transfusion rates and shorter hospital stay. In this case report, we illustrate the use of holmium laser enucleation of the prostate (HoLEP) in a gland measuring more than 400 cc. We describe the case of a 71-year-old man with persistent voiding urinary symptoms despite two previous transurethral resections of his prostate...
2016: J Endourol Case Rep
Shuichiro Kobayashi, Masataka Yano, Takayuki Nakayama, Satoshi Kitahara
PURPOSE: To determine the predictive factors for postoperative urinary incontinence (UI) following holmium laser enucleation of the prostate (HoLEP) during the initial learning period. PATIENTS AND METHODS: We evaluated 127 patients with benign prostatic hyperplasia who underwent HoLEP between January 2011 and December 2013. We recorded clinical variables, including blood loss, serum prostate-specific antigen levels, and the presence or absence of UI. Blood loss was estimated as a decline in postoperative hemoglobina levels...
July 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Portia Thurmond, Sanchita Bose, Lori B Lerner
INTRODUCTION: Holmium laser ablation of the prostate (HoLAP) is a surgical approach for treatment of benign prostatic hyperplasia (BPH). Limited evidence suggests laser ablation/vaporization is inferior to enucleation with respect to reoperation rates. Our objective was to determine if properly performed laser ablation results in outcomes similar to enucleation. MATERIALS AND METHODS: A total of 198 patients with moderate to severe lower urinary tract symptoms and/or acute urinary retention had holmium laser enucleation of the prostate (HoLEP) or HoLAP between 2008 and 2014...
August 2016: Canadian Journal of Urology
Ahmed M Elshal, Yasser Eldemerdash, Ramy Mekkawy, Diaa-Eldin Taha, Mahmoud Laymon, Ahmed R El-Nahas, Ahmed El-Assmy
OBJECTIVES: To review non-morcellation approaches for tissue retrieval after holmium laser enucleation of the prostate (HoLEP) and whether these approaches demolish the advantages of the HoLEP procedure. PATIENTS AND METHODS: We reviewed our prospectively maintained laser prostate database for HoLEP procedures where non-morcellation approaches were used for retrieval of the enucleated adenoma. Non-morcellation approaches were adopted in cases of morcellator malfunction or whenever concomitant pathology indicated laparotomy...
June 2016: Arab Journal of Urology
P Capogrosso, E Ventimiglia, M Ferrari, A Serino, L Boeri, U Capitanio, A Briganti, R Damiano, F Montorsi, A Salonia
Assess rate and predictors of erectile function (EF) outcomes at long-term follow-up (FU) after holmium laser enucleation of the prostate (HoLEP). Cross-sectional analyses were performed on 135 patients with a mean FU of 12 years post HoLEP. Patients completed both a baseline and a FU International Index of Erectile Function (IIEF)-EF domain and the International Prostatic Symptoms Score (IPSS). Postoperative EF outcomes, including rate and predictors of EF improvement considering minimal clinically important differences (MCIDs) criteria, were assessed...
September 2016: International Journal of Impotence Research
Derek J Lomas, Amy E Krambeck
OBJECTIVE: To evaluate long-term outcomes for men with benign prostatic obstruction (BPO) and concurrent detrusor underactivity (DUA) or acontractility following holmium laser enucleation of the prostate (HoLEP). METHODS: A retrospective chart review was performed on all patients with BPO and urodynamic evidence of DUA or acontractility secondary to a nonneurogenic etiology that underwent HoLEP at our institution over a 4-year period. Patients were included if they had at least 24 months of follow-up...
July 19, 2016: Urology
Songzhe Piao, Min Soo Choo, Myong Kim, Ho Joon Jeon, Seung-June Oh
PURPOSE: To evaluate the effect of age on the efficacy and safety of holmium laser enucleation of the prostate (HoLEP) for the treatment of symptomatic benign prostatic hyperplasia (BPH). METHODS: A total of 579 patients underwent HoLEP procedure performed by a single surgeon (SJO) between December 2009 and May 2013. The perioperative and functional outcomes of patients in the age groups of 50-59 (group A, n=44), 60-69 (group B, n=253), 70-79 (group C, n=244), and ≥80 years (group D, n=38) were compared...
June 2016: International Neurourology Journal
Akira Horiuchi, Satoru Muto, Shigeo Horie
BACKGROUND: To evaluate the efficacy of holmium laser enucleation of the prostate (HoLEP) followed by high-intensity focused ultrasound (HIFU) for patients with huge prostate adenoma and localized prostate cancer (CaP) and compare the morbidity and efficacy results with those observed in a similar population treated only with HIFU for a follow-up period of up to 5 years. METHODS: The present retrospective study included 30 CaP patients who underwent HIFU alone and 10 patients who underwent HoLEP followed by HIFU...
June 2016: Prostate International
Zhuo Li, Ping Chen, Jun Wang, Qi Mao, Han Xiang, Xiao Wang, Xinghuan Wang, Xinhua Zhang
Lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) is common in adult men and can impair erectile function (EF). It was believed surgical treatments for this illness can improve EF due to the relief of LUTS while they were also reported harmed EF as heating or injury effect. Current network meta-analysis aimed to elucidate this discrepancy.Randomized controlled trials (RCTs) were identified. Direct comparisons were conducted by STATA and network meta-analysis was conducted by Generate Mixed Treatment Comparison...
June 2016: Medicine (Baltimore)
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