Comparison of Holmium Laser Enucleation and Plasmakinetic Resection of Prostate: A Randomized Trial with 72-Month Follow-Up

Gu, Meng; Chen, Yan-Bo; Liu, Chong; Wan, Xiang; Cai, Zhixiang; Chen, Qi; Wang, Zhong

doi:10.1089/end.2017.0700

Cited by 30 publications

(21 citation statements)

References 21 publications

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“…Four studies reported the frequency of RE after EEP and TURP, one at month 3 23 and three at month 24. 19,20,27 As shown in the forest plot ( Fig. 6), no significant difference in RE was found between EEP and TURP (RR = 1.02, 95% CI: 0.85-1.23).…”

Section: Sexual Functionmentioning

confidence: 83%

“…Database searching yielded a total of 415 references, including 13 unpublished studies from Clinical-Trials.gov. After abstract screening and full-text review, 10 eligible studies were included for final analysis, [18][19][20][21][22][23][24][25][26][27] contributing a total sample size of 1435 patients. A summary of the characteristics of each included study is presented in Table 1.…”

Section: Search Results and Study Selectionmentioning

confidence: 99%

“…10 Indeed, the RCTs with long-term results enrolled in our analysis unanimously showed that there no reoperation was required in the EEP arm, whereas there were several cases that required reoperation in TURP or PKRP arm. 22,25,27 There were various energy sources for EEP applied in our analysis, but only one trial of thulium laser was enrolled, so the subgroup analyses were focused on the EF outcomes of HoLEP vs TURP and PKEP vs TURP, respectively. There was a significant difference favoring HoLEP with regard to IIEF-5 scores in long-term follow-up ( ‡48 months).…”

Section: Discussionmentioning

confidence: 99%

“…S1. Seven studies were judged to have low or unclear risk of bias in each domain, of which two 24,27 had low risk of bias in all domains. With the absence of blinding, three studies 21,22,25 might have a high risk of performance or detection bias.…”

Section: Quality Assessmentmentioning

confidence: 99%

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Impact on Sexual Function of Endoscopic Enucleation vs Transurethral Resection of the Prostate for Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: A Systematic Review and Meta-Analysis

Liu

Cheng

Zhuo

et al. 2020

Journal of Endourology

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Introduction: Although the transurethral resection of the prostate (TURP) has been regarded as the gold standard surgical option for lower urinary tract symptoms due to benign prostatic hyperplasia, the endoscopic enucleation of the prostate (EEP) with novel techniques is also recommended. However, whether there are differences on male sexual functions after these two procedures is still controversial. We performed this metaanalysis to investigate the impact on erectile function (EF) and ejaculation of EEP and TURP, and to explore the potential superiority between these two approaches. Materials and Methods: Literature search was conducted on Medline, Embase, and the Cochrane library, to obtain all relevant randomized controlled trials published before December 13, 2018. Outcome data were pooled and analyzed with Review Manager 5.3 to compare the International Index of Erectile Function 5 (IIEF-5) scores and retrograde ejaculation (RE) rates from short-to long-term follow-ups. Results: Ten articles with 1435 patients were included. EEP group showed higher IIEF-5 scores than TURP group with mean difference (MD) = 1.00, confidence interval (95% CI): 0.95-1.05 at 48 months and MD = 1.08, 95% CI: 1.03-1.13 at ‡60 months, respectively. In subgroup analysis, the holmium laser enucleation of the prostate showed significantly better IIEF scores than TURP group at 48 months (MD = 1.00, 95% CI: 0.95-1.05) and ‡72 months (MD = 1.08, 95% CI: 1.03-1.13). Additionally, no significant difference in RE rate was found between EEP and TURP (risk ratio = 1.02, 95% CI: 0.85-1.23). Conclusions: Compared with TURP, EEP may produce a more durable benefit for postoperative preservation of EF at long-term stage.

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Section: Sexual Functionmentioning

confidence: 83%

Section: Search Results and Study Selectionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Quality Assessmentmentioning

confidence: 99%

See 2 more Smart Citations

Impact on Sexual Function of Endoscopic Enucleation vs Transurethral Resection of the Prostate for Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: A Systematic Review and Meta-Analysis

Liu

Cheng

Zhuo

et al. 2020

Journal of Endourology

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“…Another study that compared TURP and HoLEP, assigned patients to three groups according to prostate sizes and, concerning operation length, TURP length was shorter in the 40 gr and 40-80 gr groups, and operation length was the same in the >80 gr group [21]. Gu M et al [22] compared 72-month follow-up outcomes of plasmakinetic prostate resection and HoLEP in 280 patients and found that Qmax, decrease in PSA level, International Index of Erectile Function (IIEF) score, and need for retreatment was found in favor in HoLEP. Woo MJ et al [23] compared results of TURP and HoLEP in 56 patients and six-month postoperative tests were in favor of HoLEP according to Qmax and post-void residual volume (PVR).…”

Section: Discussionmentioning

confidence: 99%

Our clinic’s first experience with HoLEP

Doğan

Yildiz

2019

North Clin Istanbul

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OBJECTIVE:The present study reports a retrospective evaluation of the first Holmium laser prostate enucleation (HoLEP) cases and their results in our clinic.METHODS:Twenty four patients who underwent HoLEP surgery between April 2017 and November 2017 were evaluated for demographic characteristics, duration of operation, amount of hemorrhage, amount of energy used, tissue weight removed, catheterization time and complications. IPSS and uroflowmetry results were compared before and after the surgery.RESULTS:Patients with hemoglobin, IPSS, uroflowmetry, and voiding speeds (Qmean, Qmax) were compared before and after the surgery. There was a significant difference in IPSS, Qmean and hemoglobin values but not in Qmax, statistically. Our complications rates were correlated with the literature.CONCLUSION:HoLEP stands out as a surgical method that can be applied with high confidence in the treatment of benign prostatic hyperplasia and it has similar functional results to gold standard surgeries, causes fewer complications, improves patient comfort due to short catheterization and hospitalization and is more advantageous regarding cost.

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Ejaculatory and erectile function outcomes following holmium laser enucleation of the prostate

Roper,

Slade,

Caras

et al. 2024

The Prostate

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PurposeHolmium laser enucleation of the prostate (HoLEP) is a surgical treatment option for benign prostatic hyperplasia (BPH). Many men develop retrograde ejaculation postprocedure, but there is conflicting evidence regarding sexual function outcomes post‐HoLEP. We sought to examine significant variations in patient‐reported erectile and ejaculatory function within 12 months post‐HoLEP.Materials and MethodsWe conducted a retrospective study for patients who underwent HoLEP between Nov 2018 and Feb 2022. Of the reviewed patients, 277 patients met inclusion criteria and completed pre and postoperative questionnaires, which included the Male Sexual Health Questionnaire‐ Ejaculatory Dysfunction (MSHQ‐EJD) and the International Index of Erectile Function/Sexual Health Inventory for Men (IIEF‐5/SHIM). Surveys were provided to patients up to 12 months postprocedure. Demographics and comorbidities associated with sexual dysfunction were collected. Responses to each question were analyzed to detect sub‐categorical variations in sexual function as the secondary objective. Data was analyzed by using a linear mixed model.ResultsThere was a significant decline in total scores for the MSHQ‐EJD (8.70 pre‐HoLEP vs. 6.58 post HoLEP, p ≤ 0.001) including a significant decline (p < 0.005) in questions 1–3 which assess ejaculatory ability, strength, and volume. There was not a significant decline in question 4 which assesses bother (2.552 pre‐HoLEP vs. 3.119 post‐HoLEP, p = 0.526). There was not a significant decline in the IIEF‐5/SHIM postoperatively (11.51 pre‐HoLEP vs. 13.327 post‐HoLEP, p = 0.498).ConclusionsPatients undergoing HoLEP do not experience a decline in erectile function. Patients do experience a decline in ejaculatory function but did not find this bothersome.

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Comparison of Holmium Laser Enucleation and Plasmakinetic Resection of Prostate: A Randomized Trial with 72-Month Follow-Up

Cited by 30 publications

References 21 publications

Impact on Sexual Function of Endoscopic Enucleation vs Transurethral Resection of the Prostate for Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: A Systematic Review and Meta-Analysis

Impact on Sexual Function of Endoscopic Enucleation vs Transurethral Resection of the Prostate for Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: A Systematic Review and Meta-Analysis

Our clinic’s first experience with HoLEP

Ejaculatory and erectile function outcomes following holmium laser enucleation of the prostate

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