Comparison of postoperative functional results in holmium laser enucleation of the prostate, green laser photovaporization of the prostate and transurethral resection of the prostate in the treatment of obstructive prostatic hyperplasia

Cruz-Ordoñez, Sandra Xochiquetzal; Chein-Vázquez, María Fernanda; Victorio-Vargas, Omar Dimas; Cervantes-Palma, César; Lemus-Hernández, Luis Alberto; Toledo-Díaz, Mario Alberto; Torres-Gómez, J.J.; Bravo-Castro, E.I.; Díaz-Gómez, C.; Martínez-Alonso, I.A.; Campos-Salcedo, J.G.

doi:10.48193/revistamexicanadeurologa.v82i3.743

Cited by 1 publication

(1 citation statement)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Few hospitals in Mexico perform HoLEP, amongst which the Central Military Hospital has the highest volume in Mexico. They recently published their experience, with 62 HoLEP cases, in a one-year period, from 2018 to 2019, with satisfying outcomes [14].…”

Section: Introductionmentioning

confidence: 99%

Adequate Mentorship Program for Holmium Laser Enucleation of the Prostate (HoLEP) Leads to Satisfactory Short-Term Outcomes in the Early Learning Curve of Young Urologists: First-Year Outcomes of a Newly Established Mentorship Training in Mexico

Martinez-Salas,

Garcia-Rivera,

Reyna-Blanco

et al. 2023

Cureus

View full text Add to dashboard Cite

IntroductionBenign prostatic hyperplasia (BPH) is one of the most common causes of lower urinary tract symptoms in men. Holmium Laser Enucleation of the Prostate (HoLEP) has been recommended by international guidelines as an alternative to transurethral resection of the prostate (TURP). HoLEP's learning curve and the lack of adequate mentorship remains an obstacle for the worldwide adoption of this technique. ObjectiveTo report the first-year learning curve of a newly established mentorship program in young urologists without any previous HoLEP experience. MethodsWe report a cohort of patients with BPH, with prostate size ≥70 grams, treated with HoLEP, analyzed for perioperative data and complications, and short-term postoperative complications and functional outcomes, at three and six months after surgery. ResultsA total of 47 patients were managed with HoLEP. Mean total operative time was 149.8 ± 42.9 minutes. We experienced five (10.6%) intraoperative complications, including one intravesical resection of the prostate with bipolar energy, three conversions to TURP and one conversion to open prostatectomy. We experienced four postoperative complications, all of them Clavien-Dindo ≤2. Median International Prostate Symptom Score (IPSS) decrease at six months was -17 points from baseline. Mean post-void residual volume and prostate-specific antigen significantly decreased by the third postoperative month. Multiple linear regression showed that prostate size is directly related to increased surgical time during the early learning curve. DiscussionOur experience adequately reflects the importance of HoLEP mentorship in young urologists seeking training in this technique. Both surgeons had perioperative and postoperative outcomes deemed satisfactory based on previously published learning curves. ConclusionsHoLEP is a technically difficult procedure, however, adequate mentorship leads to satisfying short-term outcomes since the early stages of the learning curve in young urologists with no previous training on this technique.

show abstract

Section: Introductionmentioning

confidence: 99%