Holmium laser enucleation of the prostate vs. retropubic prostatic adenomectomy: Morbidity analysis and anesthesia considerations

Soto-Mesa, Diego; Amorín-Díaz, Manuel; Pérez-Arviza, L.; Montes, S. Fernández-Pello; Martín-Huéscar, A.

doi:10.1016/j.acuroe.2015.09.007

Cited by 6 publications

(9 citation statements)

References 33 publications

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“…Concerning the value of postoperative complication rates in assessing experience, conflicting results have been reported and some groups reported fewer complications with higher caseload [13, 15, 20]. Analogous to other investigators [21, 25], we did not observe relevant changes in the here presented study.…”

Section: Discussionsupporting

confidence: 75%

Introduction of a New Score to Assess Surgical Efficiency in Holmium Laser Enucleation of the Prostate

Rosenhammer¹,

Schönhärl²,

Mayr³

et al. 2020

Urol Int

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Introduction: While holmium laser enucleation of the prostate (HoLEP) is accepted as safe and efficient, a long learning curve is considered the main reason for its slow adoption in clinical practice. So far, no standardized and easy-to-use parameter has been implemented to measure surgical experience or efficiency which could be useful for training and quality control purposes. The aim of the present study was to evaluate the learning curves of 2 HoLEP beginners and to identify applicable efficiency outcome measures as well as potentially complicating factors in performing HoLEP. Patients and Methods: A total of 594 patients treated by HoLEP between September 2016 and May 2019 were enrolled. The procedures were initially performed by 1 HoLEP expert (reference surgeon); over time, 2 further surgeons were trained. Baseline characteristics, enucleation weight, morcellation and enucleation time, laser energy usage, and postoperative results were recorded prospectively. The learning curves of the 2 novices were analyzed and compared to the reference surgeon. Logistic regression analyses were performed to identify predictors for postoperative grade ≥2 complica

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Section: Discussionsupporting

confidence: 75%

Introduction of a New Score to Assess Surgical Efficiency in Holmium Laser Enucleation of the Prostate

Rosenhammer¹,

Schönhärl²,

Mayr³

et al. 2020

Urol Int

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“…HoLEP in the learning phase requires more time than if performed by an experienced surgeon. Soto-Mesa et al [ 6 ] reported the rate of conversion from spinal anesthesia to general anesthesia in the learning phase to be higher than in the stabilization phase. Therefore, choosing the method with an appropriate length of anesthesia necessary for an extended surgical procedure time is still important.…”

Section: Discussionmentioning

confidence: 99%

“…[ 4 ] In terms of anesthetics, HoLEP surgery has several advantages, such as lower morbidity due to decreased transfusion rate and eliminating the risk of dilutional hyponatremia; however the disadvantages are associated with extended procedure time and steep learning curve. [ 5 , 6 ]…”

Section: Introductionmentioning

confidence: 99%

Comparison of epidural, spinal, and saddle block for holmium laser enucleation of prostate (HoLEP)

et al. 2021

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Background: Holmium laser enucleation of the prostate (HoLEP) has become an important treatment modality for benign prostate hypertrophy. The aim of the present study was to compare regional anesthesia methods for HoLEP operation and to determine the optimal technique. Methods: Sixty patients with American Society of Anesthesiologists scores of I-III were randomly allocated into 3 groups. Patients in group E received an epidural block with 75 mg of bupivacaine plus 50 μg of fentanyl. In group S, 15 mg of bupivacaine and 50 μg fentanyl were used for spinal anesthesia. In group SA, patients received saddle block with 15 mg of bupivacaine and 50 μg of fentanyl. Results: Time to T10 dermatome block and to maximal level block were longest in group E ( P < .05), and maximal sensorial block level was higher in group E than group SA ( P < .05). There was a significant difference in postoperative motor block, but no difference in systolic blood pressure and heart rate. Conclusion: Among 3 techniques, saddle block might be preferable in HoLEP because an adequate sensorial level was achieved with lower motor block and stable hemodynamics.

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“…One of the most serious complication after prostate surgery for BPH is stress urinary incontinence. In general, the rate of urinary incontinence that persists up to 6 months after HoLEP is 5%–18% (Cho et al., 2011; Kobayashi, Yano, Nakayama, & Kitahara, 2016; Nam et al., 2015; Shigemura, Tanaka, Yamamichi, Chiba, & Fujisawa, 2016; Soto‐Mesa, Amorín‐Díaz, Pérez‐Arviza, Fernández‐Pello Montes, & Martín Huéscar, 2015). Within 3 months after HoLEP surgery, 80% of patients recover from urinary incontinence (Nam et al., 2015).…”

Section: Anatomical Considerations In Aeepmentioning

confidence: 99%

Enucleation of the prostate: An anatomical perspective

Shitara²

2020

Andrologia

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Lower urinary tract symptoms due to benign prostatic hyperplasia (BPH) are one of the most common health problems in older men (de la Rosette et al., 1998; Madersbacher et al., 2004). Transurethral surgery is the most common surgical method for BPH. The anatomical endoscopic enucleation of the prostate (AEEP) first performed as holmium laser enucleation of prostate (HoLEP; Gilling, Kennett, Das, Thompson, & Fraundorfer, 1998). HoLEP has been known to be a safe and effective transurethral surgical technique for BPH. In addition, HoLEP is associated with a high level of patient satisfaction after

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Holmium laser enucleation of the prostate vs. retropubic prostatic adenomectomy: Morbidity analysis and anesthesia considerations

Cited by 6 publications

References 33 publications

Introduction of a New Score to Assess Surgical Efficiency in Holmium Laser Enucleation of the Prostate

Introduction of a New Score to Assess Surgical Efficiency in Holmium Laser Enucleation of the Prostate

Comparison of epidural, spinal, and saddle block for holmium laser enucleation of prostate (HoLEP)

Enucleation of the prostate: An anatomical perspective

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