En bloc and two-lobe techniques for laser endoscopic enucleation of the prostate: retrospective comparative analysis of peri- and postoperative outcomes

Enikeev, Dmitry; Taratkin, Mark; Laukhtina, Ekaterina; Алексеева, Т. М.; Snurnitsyna, Olesya; Potoldykova, Natalia V.; Герасимов, А. Н.; Glybochko, Petr

doi:10.1007/s11255-019-02259-2

Cited by 31 publications

(21 citation statements)

References 14 publications

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“…Finally, Thulium fiber laser enucleation of the prostate has been recently introduced (ThuFLEP, IPG©). If the peri-operative outcomes and erectile function are comparable to other laser sources and TURP, to our knowledge, no dedicated results regarding the ejaculatory function are available [45][46][47]. Bipolar enucleation of the prostate (BEEP) includes several procedures, such as plasmakinetic enucleation of the prostate (PkEP), transurethral resection enucleation of the prostate (TUERP), bipolar plasma enucleation of the prostate (BPEP), transurethral vapor-enucleation resection of the prostate (TVERP), transurethral vapor-enucleation of the prostate (TVEP), and finally, bipolar enucleation of the prostate (BipoLEP) [48].…”

Section: Greenlight Laser Photo Vaporization Of the Prostate (Pvp)mentioning

confidence: 99%

Ejaculations and Benign Prostatic Hyperplasia: An Impossible Compromise? A Comprehensive Review

Couteau

Duquesne

Panthier

et al. 2021

JCM

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Background: Benign prostatic hyperplasia (BPH) is commonly responsible for lower urinary tract symptoms (LUTS) in men aged 50 or over. Sexual dysfunctions, such as ejaculatory disorders (EjD), go along with LUTS but are frequently overlooked in the initial evaluation. This review aimed to detail BPH-related EjD, as well as their modifications by medical, surgical, and interventional treatments. Methods: We conducted a narrative review looking for publications between 1990 and 2020, regarding physiopathology, epidemiology, evaluation, and therapeutic management (medical, surgical, and interventional) of BPH-related EjD. Results: Sixty-five articles were included in our final analysis. Forty-six percent of men presenting with LUTS reported EjD. If the prevalence increases with age and LUTS severity, the functional impairment is not correlated with age. Several self-questionnaires evaluated the sexual function, but only four approaches are specific to EjD. Medical therapies were exposed to anejaculation, rather than retrograde ejaculation (RE) (4–30% (alpha-blockers), 4–18% (5-alpha-reductase inhibitors)). Regarding surgical therapies, trans-urethral resection of the prostate (TURP) and incision of the prostate (TUIP) are associated with 50–70% and 21–35% of RE. The RE rate is important after open simple prostatectomy but can be reduced with robotic approaches and urethral sparing techniques (19%). Anatomic endoscopic enucleation of the prostate (AEEP) with or without a laser source is associated with an 11–36% RE rate, according to supramontanal preservation. Recent surgical techniques (Rezum©, Aquablation©, or Urolift©) were developed to preserve antegrade ejaculation with promising short-term results. Regardless of the surgical approach, anatomic studies suggest that the preservation of peri-montanal tissue (7.5 mm laterally; 10 mm proximally) is primordial to avoid post-operative RE. Finally, prostate artery embolization (PAE) limits the RE rate but exposes it to a 12 months 10% re-intervention rate. Conclusion: EjD concerns almost half of the patients presenting BPH-related LUTS. Initial evaluation of EjD impairment is primordial before medical or surgical therapy. Peri-montanal tissue preservation represents a key point for antegrade ejaculation preservation, regardless of the surgical option.

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Section: Greenlight Laser Photo Vaporization Of the Prostate (Pvp)mentioning

confidence: 99%

Ejaculations and Benign Prostatic Hyperplasia: An Impossible Compromise? A Comprehensive Review

Couteau

Duquesne

Panthier

et al. 2021

JCM

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“…However, comparative assessment of effectivity is inconclusive. Enikeev et al demonstrate in favour of two‐lobe technique a faster morcellation in large prostates when compared to en bloc technique AEEP (Enikeev et al, 2019). However, other authors investigated traditional three‐lobe HoLEP versus HoLEP en bloc, concluding that en bloc resulted in reduction of total operative time.…”

Section: Surgical Resultsmentioning

confidence: 99%

Transurethral anatomical enucleation of the prostate with Tm:YAG support (ThuLEP): Evolution and variations of the technique. The inventors' perspective

Herrmann

Wolters

2020

Andrologia

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Rome ne fu pas faite toute en un jour (Tobler, 1895). In the world of Endourology, the fact that good things need time to ripen was fully proven by evolution of Endoscopic Enucleation of the Prostate (EEP). This term was introduced in the 2016 update of the EAU Guidelines on Management of Non-Neurogenic Male Lower Urinary Tract Symptoms (LUTS) with the reception of two meta-analysis (Gratzke et al., 2015; Li et al., 2015; Lin et al., 2015), promoting EEP for the first time as the preferred treatment of choice for the treatment Benign Prostatic Obstruction (BPO) of large volume prostatic glands. This resulted in the change of

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“…Another ex-vivo study by the same group found that utilising a 110 W TFL tissue-ablation rate increased by four-fold 40 W [ 21 ]. Enikeev et al reported no significant difference between HoLEP and ThuFLEP in terms of enucleation rates (1.9 ± 0.74 g/min vs 1.9 ± 0.69 g/min; p = 0.217) [ 22 ]. However, in the present study, we found that the TFL was on average less efficient (cm 2 /min) than the HP-Ho:YAG, but more efficient than the LP-Ho:YAG.…”

Section: Discussionmentioning

confidence: 99%

Experimental ex-vivo performance study comparing a novel, pulsed thulium solid-state laser, chopped thulium fibre laser, low and high-power holmium:YAG laser for endoscopic enucleation of the prostate

et al. 2021

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Purpose The aim of this study was to compare the enucleation performances of four different types of laser devices in an ex-vivo experiment: a novel, pulsed Tm:YAG solid-state laser evaluation model (p-Tm:YAG), chopped thulium fibre laser (TFL), low-power Ho:YAG laser (LP-Ho:YAG), and a high-power Ho:YAG laser (HP-Ho:YAG). Methods Our primary aim was to endoscopically separate the fascial layers of a porcine belly using laser fibres within a time period of 60 s. The size of a “tissue pocket” was assessed numerically. The enucleation characteristics reflecting the surgeon’s experience were evaluated via the NASA Task Load Index (TLX) questionnaire and a questionnaire based on Likert scale. Results HP-Ho:YAG achieved with the available laser settings the largest overall “tissue pocket” (31.5 cm2) followed by p-Tm:YAG (15 cm2), TFL (12 cm2), and LP-Ho:YAG (6 cm2). The coagulation performances of p-Tm:YAG and TFL were rated the best. In the performance evaluation by the Likert questionnaire, HP-Ho:YAG (average score of 4.06) was rated highest, followed by p-Tm:YAG (3.94), TFL (3.38), and LP-Ho:YAG (3.25). The evaluation of the NASA-TLX performance questionnaire revealed average scores for HP-Ho:YAG, LP-Ho:YAG, TFL and p-Tm:YAG of 4.38, 4.09, 3.92 and 3.90, respectively. Conclusion We are the first to compare different laser devices and settings in an ex-vivo study. We found that the surgeons were most satisfied with the HP-Ho:YAG laser device, followed by the p-Tm:YAG. These findings could be highly relevant for future research and for the practical utilisation of laser systems in endourology.

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En bloc and two-lobe techniques for laser endoscopic enucleation of the prostate: retrospective comparative analysis of peri- and postoperative outcomes

Cited by 31 publications

References 14 publications

Ejaculations and Benign Prostatic Hyperplasia: An Impossible Compromise? A Comprehensive Review

Ejaculations and Benign Prostatic Hyperplasia: An Impossible Compromise? A Comprehensive Review

Transurethral anatomical enucleation of the prostate with Tm:YAG support (ThuLEP): Evolution and variations of the technique. The inventors' perspective

Experimental ex-vivo performance study comparing a novel, pulsed thulium solid-state laser, chopped thulium fibre laser, low and high-power holmium:YAG laser for endoscopic enucleation of the prostate

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