A Systematic Review of Holmium Laser Prostatectomy for Benign Prostatic Hyperplasia

Tooher, Rebecca; Sutherland, Peter; Costello, Anthony J.; Gilling, Peter; Rees, Guy; Maddern, Guy J.

doi:10.1097/01.ju.0000113494.03668.6d

Cited by 130 publications

(60 citation statements)

References 50 publications

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“…Introduction of the Holmium laser represented a turning point in minimally invasive laser therapy for BPH, as it achieves size-independent prostatic cavity similar to simple open prostatectomy with significantly low-DOI: 10.1159/000499092 er perioperative morbidity [1]. The Holmium laser has rapidly gained a lot of acceptance supported by well-designed randomized controlled trials and meta-analyses [2][3][4]. As a result, recent AUA and EAU guidelines now incorporate holmium laser enucleation of the prostate (HoLEP) as an alternative option for treatment of symptomatic BPH with a high level of evidence to support its efficacy and safety [5,6].…”

mentioning

confidence: 99%

The ex vivo and in vivo Characteristics of New DrillCut<sup>TM</sup> Prostate Morcellator after Holmium Laser Enucleation of the Prostate: A Pilot Study

et al. 2019

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Introduction: The DrillCut^TM morcellator is marketed for its fast and highly efficient removal of prostatic tissue and a higher level of patient safety. However, a paucity of publications has looked into its actual efficacy and safety. The aim of our study was to evaluate its ex vivo and in vivo efficiency and to compare its results with other devices presented in the literature. Patients and Methods: We conducted a prospective pilot study on patients who underwent holmium laser enucleation of the prostate (HoLEP) from 2017 to 2018 using the Top-Down technique. Enucleated adenomas were morcellated using the DrillCut^TM morcellator. We collected both preoperative and operative data. Operative data included the enucleated adenoma weight and operative time. Various morcellator parameters were collected including morcellation time and efficiency. We recorded the encountered complications and device malfunction. Ex vivo characteristics were evaluated in terms of morcellation speed and aspiration power. Results: Sixty consecutive patients with a median age of 72.8 years were included. The enucleated adenoma was retrieved in 12.5 min (4–58). The median resected prostatic weight was 90 g (44–242). The DrillCut^TM efficiency was calculated as 6.46 g/min (2.7–15). Only one patient had a simple bladder mucosal injury. Device malfunction was encountered in 4 patients (6.6%) due to blockage of the morcellator blades. The ex vivo aspiration speed was 52 s/L, while the morcellation power was 14 g/2 min. Conclusion: Our results showed that the DrillCut morcellator was effective and safe in managing our patients post-HoLEP. The DrillCut^TM has better ex vivo morcellation power but modest aspiration speed in comparison to other morcellators.

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mentioning

confidence: 99%

The ex vivo and in vivo Characteristics of New DrillCut<sup>TM</sup> Prostate Morcellator after Holmium Laser Enucleation of the Prostate: A Pilot Study

et al. 2019

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“…3 In meta-analysis of studies comparing the HoLEP with the other minimally invasive surgical modalities have found that HoLEP was at least equal or superior to the other methods in terms of efficacy and safety. 4,5 The aim of this study is to assess the effect of HoLEP on erectile function during the twelve months follow-up period.…”

Section: Impact Of Holmium Laser Enucleation Of Prostate On Erectile mentioning

confidence: 99%

Impact of Holmium Laser Enucleation of Prostate on Erectile Function: Results of 12 Months Follow-Up

Alkan¹,

Pelit²,

Canat³

et al. 2017

J Reconstr Urol

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A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : To evaluate erectile function in patients with symptomatic benign prostatic hyperplasia (BPH) treated by Holmium laser enucleation of the prostate (HoLEP) operation. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : We retrospectively reviewed our recorded data on BPH patients treated by HoLEP between May 2002 -December 2016. 106 patients were enrolled to the study. International Index of Erectile Function-5 (IIEF-5) questionnaires were completed both before the operation and during the follow-up period. First 12 months results on surgical outcome and erectile function after HoLEP were given in this study. R Re es su ul lt ts s: : A total of 106 patients with a mean age 73.2 ± 4.5 years old were included in this study. The mean volume of the prostate was 77.5 ± 32.3 mL. Mean operative time was 92.6 ± 33.8 min. Total energy which was used during the surgery was 203.5 ± 120 kj. Mean morcelation time was 14.2 ± 11.6 min. Catheterization and hospitalization times were 1.2 ± 0.7 day and 1.1 ± 0.5 day respectively. The mean preoperative IIEF-5 score was 16.5 ± 6. The mean values at 1, 3, 6 months, 12 months were 15.9 ± 3.5, 15.7 ± 4.5, 16.2 ± 2.9, 16.4 ± 3.8, respectively (P >05). There was no significant difference in the mean IIEF-5 scores compared with the preoperative scores during 12 months follow-up period. C Co on nc cl lu us si io on n: : HoLEP is a safe and effective method of treatment for BPH patients. The short-term surgical outcomes from the point of score on the Turkish version of the International Prostate Symptom Score (IPSS), the maximum flow rate (Qmax) values, and post-voiding residual urine volume (PVR) were excellent. During the 12 months followup period, HoLEP has no negative impact on erectile function with no appreciable decrease on IIEF-5 scores.K Ke ey yw wo or rd ds s: : Prostatic hyperplasia; holmium; laser therapy; erectile dysfunction Ö ÖZ ZE ET T A Am ma aç ç: : Holmium lazer prostat enükleasyonu operasyonu (HoLEP) ile tedavi olan semptomatik iyi-huylu prostat hiperplazisi (BPH) li hastaların erektil fonksiyonlarını değerlendirmek. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Mayıs 2002-Aralık 2016 tarihleri arasında BPH nedeniyle opere edilen hastaların verileri geriye dönük olarak gözden geçirildi. 106 hasta çalışmaya dahil edildi. Uluslararası Erektil Fonksiyon İndeksi-5 (IIEF-5) sorgulama formu, operasyon öncesi ve takip periyodu süresince dolduruldu. Bu çalışmada, HoLEP operasyonunun cerrahi sonuçları ve erektil fonksiyona etkisinin ilk 12 aylık sonuçları değerlendirildi. B Bu ul lg gu ul la ar r: : Çalışmaya dahil edilen 106 hastanın ortalama yaşı 73.2 ± 4.5 yıl idi. Ortalama prostat hacmi 77.5 ± 32.3 mL idi. Ortalama operasyon süresi 92.6 ± 33 dk ve operasyonda kullanılan total enerji 203.5 ± 120 kj idi. Ortalama morselasyon süresi 14.2 ± 11 dk iken, ortalama kateterizasyon ve yatış süresi sırasıyla; 1.2 ± 0.7 ve 1.1 ± 0.5 gündü. Preoperatif ortalama IIEF-5 skoru 16.5 ± 6. 1, 3, 6 ayda ve 12 ayda ortalama ...

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“…Among above mentioned modalities, the laser ablation-based treatment is called the laser prostatectomy [55][56][57]. The laser prostatectomy is performed by shooting the pulse laser to the abnormal prostate and enlarging the passage for the urine.…”

Section: Trends and Future Direction Of Lasers In Urologymentioning

confidence: 99%

The Advent of Laser Therapies in Dermatology and Urology: Underlying Mechanisms, Recent Trends and Future Directions

Lee

Jeong

Chan³

2009

Journal of the Optical Society of Korea

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Following their applications in cardiology, ophthalmology and dentistry among others, the advent of lasers in dermatology and urology had become the success story of the past decade. Laser-assisted treatments in dermatology and urology are mainly based on the laser-induced tissue injury/coagulation and/or ablation, depending upon the desirable clinical endpoint. In this review, we discussed the underlying mechanisms of the laser induced tissue ablation. In any medical laser application, the controlled thermal injury and coagulation, and the extent of ablation, if required, are critical. The laser thermal mechanism of injury is intricately related to the selective absorption of light and its exposure duration, similarly to the laser induced ablation. The laser ablation mechanisms were categorized into four different categories (the photo-thermally induced ablation, the photo-mechanically induced ablation, the plasma induced ablation and the photoablation) and their fundamentals are herein described. The brief history of laser treatment modality in dermatology and urology are summarized.

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A Systematic Review of Holmium Laser Prostatectomy for Benign Prostatic Hyperplasia

Cited by 130 publications

References 50 publications

The ex vivo and in vivo Characteristics of New DrillCut<sup>TM</sup> Prostate Morcellator after Holmium Laser Enucleation of the Prostate: A Pilot Study

The ex vivo and in vivo Characteristics of New DrillCut<sup>TM</sup> Prostate Morcellator after Holmium Laser Enucleation of the Prostate: A Pilot Study

Impact of Holmium Laser Enucleation of Prostate on Erectile Function: Results of 12 Months Follow-Up

The Advent of Laser Therapies in Dermatology and Urology: Underlying Mechanisms, Recent Trends and Future Directions

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