Efficacy of Holmium Laser Enucleation of the Prostate in Patients with a Small Prostate (≤30 mL)

Park, Sejun; Kwon, Taekmin; Park, Sungchan; Moon, Kee‐Chan

doi:10.5534/wjmh.17011

Cited by 18 publications

(20 citation statements)

References 30 publications

(44 reference statements)

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“…In previous studies on such complications, no differences were reported in terms of urgency, dysuria, and transient incontinence between the TURP and HoLEP groups [7]. In another study, 5 cases of blood transfusion requirement and 38 cases of transient incontinence were noted among 459 patients who underwent HoLEP [19].…”

Section: Discussionmentioning

confidence: 98%

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Comparison of the Efficacy of Holmium Laser Enucleation of the Prostate in Treating Prostate Volumes of ≤80 and > 80 mL

Gazel

Kaya²,

Yalçın³

et al. 2019

Urol Int

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Introduction: Holmium laser enucleation of the prostate (HoLEP) is becoming the new standard procedure for treating benign prostatic hyperplasia (BPH), a common condition in aging men. Most studies have focused on proving its efficacy in treating large prostates. In this study, we compared its efficacy in treating small (< 80 mL) and large (> 80 mL) prostates. Methods: This prospective study included 119 patients with BPH who underwent HoLEP by the same surgeon between June 2015 and December 2017. They were divided into 2 groups according to their prostate volumes (≤80 mL: Group 1; > 80 mL: Group 2). Various pre- and postoperative parameters were compared within and between the groups. Results: International Prostate Symptom Score (IPSS), postvoid residual (PVR) volume, and voiding time (VT) significantly decreased, and the peak urinary flow rate (Qmax), average urinary flow rate (Qave), and quality of life (QoL) score significantly increased postoperatively in both groups. The postoperative changes in IPSS, QoL score, Qmax, Qave, VT, PVR volume, and hemoglobin levels were not significantly different between the groups. In addition, no significant difference was observed in postoperative complications between the groups. Conclusions: Our results indicate that HoLEP is an effective procedure for treating both small and large prostates.

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Section: Discussionmentioning

confidence: 98%

“…HoLEP is a unique method that can be performed independent of the prostate size. Although there are many studies on the use of HoLEP in large prostates [2][3][4]6], studies on it use in small prostates are limited [7,8].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Efficacy of Holmium Laser Enucleation of the Prostate in Treating Prostate Volumes of ≤80 and > 80 mL

Gazel

Kaya²,

Yalçın³

et al. 2019

Urol Int

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“…Although HoLEP is addressed as a surgical treatment option of small prostate flow chart in AUA guidelines, it is still stayed behind transurethral incision of the prostate and transurethral resection of the prostate (TURP) for small prostate treatment options in EAU guidelines (Foster et al., 2018; Gratzke et al., 2015). The effect of prostate size on the outcome of HoLEP surgery has been studied in the literature; most of the published papers compared the large prostates above 80 or 100 ml (Gazel et al., 2019; Glybochko et al., 2017; Hettiarachchi et al., 2002; Jones et al., 2016; Kuntz et al., 2008; Zhang et al., 2020) and some compared small prostates below 40 or 30 ml (Kim et al., 2016, 2019; Park et al., 2017).…”

Section: Introductionmentioning

confidence: 99%

Comparison of outcomes of Holmium enucleation of the prostate for small‐ and moderate‐sized prostates

Yılmaz¹,

Yalçın²,

Yılmaz

et al. 2021

Andrologia

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There is an ongoing discussion in the literature on the surgical treatment option for small prostate size benign prostate hyperplasia (BPH) patients. This study aimed to evaluate the efficacy of Holmium laser enucleation of the prostate (HoLEP) surgery in small (<30 ml) and moderate (30–80 ml) prostate size as accepted in European Association of Urology guideline. We retrospectively analysed our database between May 2016 and May 2019 and patients who underwent HoLEP surgery. Patients who have prostate size <80 ml were included the study. These patients were divided into two group: group 1 with prostate size <30 ml (n: 64) and group 2 with prostate size 30–80 ml (n: 101). Enucleation time (ET), morcellation time (MT), total operation time (OT), enucleation efficiency (EE), morcellation efficiency (ME), intra‐ and post‐operative complications were analysed. While EE and Hb drop were better in favour of group 2; PSA drop, ET, MT, OT and ME were superior in favour of group 1. In group 1, intra‐operative complications were higher (6 vs. 2; p < .05) and post‐operative complications did not differ statistically between groups (p = .14). No statistically significant finding was found between groups regarding incontinence. In conclusion, HoLEP is a reliable method in terms of its results in patients with small prostates.

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“…BNCs and capsular perforations are of concern in these patients due to high energy delivered to the tissue creating scarring of the bladder neck [6], [15]. There have only been a few studies evaluating the efficacy of BPH surgery in patients with small volume prostates [16], [17], [18]. However, due to the paucity of literature addressing the 180 W PVP in small prostates [16], [17], [18], it remains unclear the effectiveness of 180 W PVP for this cohort of patients.…”

Section: Introductionmentioning

confidence: 99%

“…There have only been a few studies evaluating the efficacy of BPH surgery in patients with small volume prostates [16], [17], [18]. However, due to the paucity of literature addressing the 180 W PVP in small prostates [16], [17], [18], it remains unclear the effectiveness of 180 W PVP for this cohort of patients. We sought to assess the safety and efficacy of the 180 W XPS-GreenLight laser in patients with a BPH volume ≤40 mL.…”

Section: Introductionmentioning

confidence: 99%

The role of photovaporization of the prostate in small volume benign prostatic hyperplasia and review of the literature

Thomas

Zorn

Meskawi

et al. 2019

Asian Journal of Urology

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ObjectiveOur objective was to characterize the safety and efficacy of the 180 W XPS-GreenLight laser in men with lower urinary tract symptoms secondary to a small volume benign prostatic hyperplasia (BPH).MethodsA retrospective analysis was performed for all patients who underwent 180 W XPS-laser photoselective vaporization of the prostate (PVP) vaporization of the prostate between 2012 and 2016 at two-tertiary medical centers. Data collection included baseline comorbidities, disease-specific quality of life scores, maximum urinary flow rate (Qmax), postvoid residual (PVR), complications, prostate volume and prostate-specific antigen (PSA). The secondary endpoints were the incidence of intraoperative and postoperative adverse events. Complications were stratified using the Clavien-Dindo grading system up to 90 days after surgery.ResultsMean age of men was 67.8 years old, with a mean body mass index of 29.7 kg/m2. Mean prostate volume as measured by transrectal ultrasound was 29 mL. Anticoagulation use was 47% and urinary retention with catheter at time of surgery was 17%. Mean hospital stay and catheter time were 0.5 days. Median follow-up time was 6 months with the longest duration of follow-up being 22.5 months (interquartile range, 3–22.5 months). The International Prostate Symptom Score improved from 22.8 ± 7.0 at baseline to 10.7 ± 7.4 (p < 0.01) and 6.3 ± 4.4 (p < 0.01) at 1 and 6 months, respectively. The Qmax improved from 7.70 ± 4.46 mL/s at baseline to 17.25 ± 9.30 mL/s (p < 0.01) and 19.14 ± 7.19 mL/s (p < 0.001) at 1 and 6 months, respectively, while the PVR improved from 216.0 ± 271.0 mL preoperatively to 32.8 ± 45.3 mL (p < 0.01) and 26.2 ± 46.0 mL (p < 0.01) at 1 and 6 months, respectively. The PSA dropped from 1.97 ± 1.76 ng/mL preoperatively to 0.71 ± 0.61 ng/mL (p < 0.01) and 0.74 ± 0.63 ng/mL at 1 and 6 months, respectively. No patient had a bladder neck contracture postoperatively and no capsular perforations were noted intraoperatively.ConclusionThe 180 W GreenLight XPS system is safe and effective for men with small volume BPH. PVP produced improvements in symptomatic and clinical parameters without any safety concern. It represents a safe surgical option in this under studied population.

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Efficacy of Holmium Laser Enucleation of the Prostate in Patients with a Small Prostate (≤30 mL)

Cited by 18 publications

References 30 publications

Comparison of the Efficacy of Holmium Laser Enucleation of the Prostate in Treating Prostate Volumes of ≤80 and > 80 mL

Comparison of the Efficacy of Holmium Laser Enucleation of the Prostate in Treating Prostate Volumes of ≤80 and > 80 mL

Comparison of outcomes of Holmium enucleation of the prostate for small‐ and moderate‐sized prostates

The role of photovaporization of the prostate in small volume benign prostatic hyperplasia and review of the literature

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Efficacy of Holmium Laser Enucleation of the Prostate in Patients with a Small Prostate (≤30 mL)

Cited by 18 publications

References 30 publications

Comparison of the Efficacy of Holmium Laser Enucleation of the Prostate in Treating Prostate Volumes of ≤80 and &#x3e; 80 mL

Comparison of the Efficacy of Holmium Laser Enucleation of the Prostate in Treating Prostate Volumes of ≤80 and &#x3e; 80 mL

Comparison of outcomes of Holmium enucleation of the prostate for small‐ and moderate‐sized prostates

The role of photovaporization of the prostate in small volume benign prostatic hyperplasia and review of the literature

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Product

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Comparison of the Efficacy of Holmium Laser Enucleation of the Prostate in Treating Prostate Volumes of ≤80 and > 80 mL

Comparison of the Efficacy of Holmium Laser Enucleation of the Prostate in Treating Prostate Volumes of ≤80 and > 80 mL