Comparison of Holmium Laser Prostate Enucleation Outcomes in Patients with or without Preoperative Urinary Retention

Johnsen, Niels V.; Kammann, Trisha J.; Marien, Tracy; Pickens, Ryan B.; Miller, Nicole L.

doi:10.1016/j.juro.2015.10.116

Cited by 19 publications

(31 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a comparison study between urinary retention patients and patients who could void spontaneously before HoLEP, perioperatively the urinary retention group had a lower blood transfusion rate and did not require long-term recatheterization. 27,28 Postoperatively, peak urinary flow was higher in men without urinary retention at 6-and 12-month follow up, but similar to men with initial urinary retention at longer follow up. Taken together, HoLEP is a good tool for addressing urinary retention in men, with a 100% rate of postoperative spontaneous voiding and no differences in the complication rate.…”

Section: Urinary Retentionmentioning

confidence: 76%

“…reported that all patients in their series were voiding spontaneously after HoLEP without major complications. In a comparison study between urinary retention patients and patients who could void spontaneously before HoLEP, perioperatively the urinary retention group had a lower blood transfusion rate and did not require long‐term recatheterization . Postoperatively, peak urinary flow was higher in men without urinary retention at 6‐ and 12‐month follow up, but similar to men with initial urinary retention at longer follow up.…”

Section: Urinary Retentionmentioning

confidence: 94%

See 1 more Smart Citation

Current status of holmium laser enucleation of the prostate

Shigemura

Fujisawa

2017

Int J of Urology

View full text Add to dashboard Cite

There are several options for the surgical management of benign prostatic hyperplasia representatively from transurethral resection of the prostate. Holmium laser enucleation of the prostate is one of those options, and many institutions and urologists have initiated this technique, and most of them have accomplished better outcomes compared with transurethral resection of the prostate. In contrast to transurethral resection of the prostate, which requires a similar procedure to transurethral resection of bladder tumors, holmium laser enucleation of the prostate requires a special surgical technique: enucleation and morcellation with around 10 years' history of experience, even in Japan. The present review introduces the current status of holmium laser enucleation of the prostate, so that it surely contributes to the knowledge of International Journal of Urology readers who could be experienced surgeons or beginners as well.

show abstract

Section: Urinary Retentionmentioning

confidence: 76%

Section: Urinary Retentionmentioning

confidence: 94%

Current status of holmium laser enucleation of the prostate

Shigemura

Fujisawa

2017

Int J of Urology

View full text Add to dashboard Cite

show abstract

“…26,27 Peterson et al reported on their experience with 164 men undergoing HoLEP for urinary retention 27. Following HoLEP, all patients were voiding spontaneously and no major complications were reported.…”

Section: Resultsmentioning

confidence: 99%

“…Following HoLEP, all patients were voiding spontaneously and no major complications were reported. A more contemporary series compared the outcomes of 95 patients in urinary retention to 136 men who were voiding spontaneously prior to HoLEP 26. Perioperatively, men in urinary retention were less likely to require a blood transfusion (1.0% vs 4.4%, P =0.01).…”

Section: Resultsmentioning

confidence: 99%

Holmium laser enucleation of the prostate: patient selection and perspectives

Marien

Kadıhasanoğlu

Miller

2016

RRU

Self Cite

View full text Add to dashboard Cite

BackgroundMultiple endoscopic surgical options exist to treat benign prostatic hyperplasia (BPH), including holmium laser enucleation of the prostate (HoLEP). HoLEP alleviates obstructive prostatic tissue via enucleation, both bluntly with a resectoscope and by cutting tissue with the holmium laser, and removal of adenoma via morcellation. This article reviews patient selection for HoLEP in order to optimize outcomes, costs, and patient satisfaction.MethodsA literature review of all studies on HoLEP was conducted. Studies that focused on outcomes in regard to patient and procedural factors were closely reviewed and discussed.ResultsVarious studies found that men with large or small prostates, on antithrombotic therapy, in urinary retention, with bladder hypocontractility, with prostate cancer, undergoing retreatment for BPH, or in need of concomitant surgery for bladder stones and other pathologies do well with HoLEP, as demonstrated by excellent functional and symptomatic outcomes as well as low complication rates. There is a 74–78% rate of retrograde ejaculation following HoLEP. Techniques to preserve ejaculatory function following enucleative techniques have not been able to demonstrate a significant improvement.ConclusionPatient selection for HoLEP can include most men with bothersome BPH who have evidence of bladder outlet obstruction and are healthy enough to undergo surgery. The ability to safely perform concomitant surgery with HoLEP benefits the patient by sparing them an additional anesthetic and also decreases costs. Patients should be made aware of the risk of retrograde ejaculation following HoLEP and counseled on treatment alternatives if maintaining ejaculatory function is desired.

show abstract

“…However, there was no significant difference in the decrease in hemoglobin levels and transfusion need [36]. Since the development of urinary retention depends on obstruction operations due to BPH, various studies that investigated the reliability of HoLEP indicated that functional outcomes were the same in both patients that developed and did not develop postoperative recurrent retention [37, 38]. Although HoLEP was determined to be reliably performed in patients with bladder stones among pathologies requiring surgical treatment, the number of studies is limited [39], which should be researched.…”

Section: Discussionmentioning

confidence: 99%

Our clinic’s first experience with HoLEP

Doğan

Yildiz

2019

North Clin Istanbul

View full text Add to dashboard Cite

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.

show abstract

Comparison of Holmium Laser Prostate Enucleation Outcomes in Patients with or without Preoperative Urinary Retention

Cited by 19 publications

References 19 publications

Current status of holmium laser enucleation of the prostate

Current status of holmium laser enucleation of the prostate

Holmium laser enucleation of the prostate: patient selection and perspectives

Our clinic’s first experience with HoLEP

Contact Info

Product

Resources

About