Holmium Laser Enucleation Versus Bipolar Plasmakinetic Resection for Management of Lower Urinary Tract Symptoms in Patients with Large-Volume Benign Prostatic Hyperplasia: Randomized-Controlled Trial

Habib, E; ElSheemy, Mohammed S.; Hossam, Ahmed; Morsy, Salem; Hussein, Hussein Aly; Abdelaziz, Ahmed; Abdelazim, Mohammed; Fathy, Heba

doi:10.1089/end.2020.0636

Cited by 21 publications

(28 citation statements)

References 14 publications

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“… 37 From the above results, we can find that PKRBT has huge advantages over PC. PKRBT is low-temperature (40–70°C) cutting, with weak heat permeability, low probability of bladder muscle perforation, 38 and obvious hemostatic effect. It may be due to the fact that transurethral resection is helpful to produce gasification layer and coagulation layer, which can significantly inhibit the occurrence of blood vessel hemorrhage, and effectively occlude small blood vessels and lymphatic vessels, contributing to the prevention of tumor cell metastasis.…”

Section: Discussionmentioning

confidence: 99%

Clinical Efficacy and Quality of Life Assessment of Partial Cystectomy and Plasmakinetic Transurethral Resection of Tumor in Bladder Cancer Patients

Li¹,

Wang²,

Zhi-hu³

2022

CMAR

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Objective Bladder cancer is a common malignant tumor of the urinary system, with an incidence ranking the first in the urinary system. Without timely and effective treatment, the tumor may spread to other parts of the body. Traditional partial cystectomy (PC) and plasmakinetic transurethral resection of bladder tumor (PKRBT) are common surgical methods for superficial bladder cancer (SBC). This study aims to clarify the clinical efficacy of bladder carcinoma (BC) patients treated by either PC or PKRBT and their effects on the quality of life (QOL) of patients. Methods A total of 142 patients with SBC treated in Wenzhou Central Hospital and Bei da huang Industry Group General Hospital from March 2018 to June 2020 were analyzed retrospectively. According to the surgical method, patients undergoing PKRBT were included in the research group (n = 74) while those treated by PC were included in the control group (n = 69). Surgical indicators (intraoperative blood loss, IBL; operating time, OT; bladder irrigation time; catheter retention time; length of hospital stay, LOS), postoperative complication rate, and one-year recurrence rate were compared between the two groups. Besides, the levels of inflammatory factors [tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10], psychological and emotional scores (Self-Rating Anxiety Scale, SAS; Self-Rating Depression Scale, SDS), and living conditions (Pittsburgh Sleep Quality Index, PSQI) before and after treatment were compared. Results Compared with the control group, patients in the research group had 1) less IBL, less time of OT, bladder irrigation and indwelling catheter time, as well as shorter postoperative LOS; 2) lower contents of inflammatory factors TNF-α, IL-6 and IL-8, and higher IL-10; 3) lower SAS and SDS scores and higher PSQI; and 4) fewer postoperative complications and lower one-year recurrence rate. Conclusion Compared with PC, PKRBT contributes to higher efficacy and better postoperative QOL in patients SBC.

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Section: Discussionmentioning

confidence: 99%

Clinical Efficacy and Quality of Life Assessment of Partial Cystectomy and Plasmakinetic Transurethral Resection of Tumor in Bladder Cancer Patients

Li¹,

Wang²,

Zhi-hu³

2022

CMAR

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“…HoLEP (Lumenis Medical Systems, Santa Clara, CA, USA) and B-TURP (KLS Martin Maxium; Covidien Force Triad, Tuttlingen, Germany) procedures were performed according to a method previously described. 2 Both procedures were performed by three experienced surgeons. Anticoagulants were replaced by low-molecular-weight heparin, which was discontinued 12 h before the procedure.…”

Section: Methodsmentioning

confidence: 99%

“…1 Furthermore, the guidelines state that high-level evidence for larger prostates (>80 cc) is limited to only a few RCTs, 1 while there are even fewer RCTs directly comparing HoLEP with B-TURP for large prostates. 2,3 Although HoLEP is a standard treatment for the management of large prostate glands, it requires experience and skills, and is also expensive. This may limit the widespread use of HoLEP and other enucleation techniques.…”

Section: Introductionmentioning

confidence: 99%

Holmium laser enucleation versus bipolar resection in the management of large‐volume benign prostatic hyperplasia: A randomized controlled trial

et al. 2021

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Abbreviations & Acronyms AC/AP = anticoagulants/ antiplatelets BPH = benign prostatic hyperplasia B-TURP = bipolar transurethral resection of prostate CI = confidence interval Hb = hemoglobin HoLEP = holmium laser enucleation of the prostate IPSS = International Prostate Symptom Score LUTS = lower urinary tract symptoms MMM = morcellator/machine malfunction M-TURP = monopolar transurethral resection of the prostate OR = odds ratio PSA = prostate-specific antigen PVRU = post-void residual urine Q max = maximum urinary flow rate QoL = quality of life RCT = randomized controlled trial SUI = stress urinary incontinence TRUS = transrectal ultrasonography TURP = transurethral resection of the prostate US = ultrasonography UTI = urinary tract infection

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“…However, BPEP required a longer catheterization duration and operative time [ 3 ]. Another RCT conducted to compare HoLEP versus bipolar plasmakinetic resection for large BPH (≥75g) showed that HoLEP had better safety profile, with significantly less operative duration, hemoglobin loss, hospital stay, and catheterization duration [ 4 ]. Although both procedures were effective, HoLEP showed significantly better percentage improvement of both IPSS and QoL [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…Another RCT conducted to compare HoLEP versus bipolar plasmakinetic resection for large BPH (≥75g) showed that HoLEP had better safety profile, with significantly less operative duration, hemoglobin loss, hospital stay, and catheterization duration [ 4 ]. Although both procedures were effective, HoLEP showed significantly better percentage improvement of both IPSS and QoL [ 4 ]. To the best of our knowledge, there are no studies conducted to date evaluating efficacy and safety of B-TUVP vs other endourological modalities in men with prostates larger than 80 mL.…”

Section: Introductionmentioning

confidence: 99%

Short-term efficacy and safety of second generation bipolar transurethral vaporization of the prostate (B-TUVP) for large benign prostate enlargement: Results from a retrospective feasibility study

et al. 2021

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Background To investigate the efficacy and safety of a second-generation bipolar transurethral electro vaporization of the prostate (B-TUVP) with the new oval-shaped electrode for large benign prostatic enlargement (BPE) with prostate volume (PV) ≥100ml. Materials and methods 100 patients who underwent second-generation B-TUVP with the oval-shaped electrode for male lower urinary tract symptom (LUTS) or urinary retention between July 2018 and July 2020 were enrolled in this study. The patients’ characteristics and treatment outcome were retrospectively compared between patients with PV <100ml and ≥100ml. Results 17/41 (41.5%) cases of PV ≥100ml and 24/59 cases (40.7%) of PV <100ml were catheterised due to urinary retention. The duration of post-operative catheter placement and hospital-stay of PV ≥100ml (3.1±1.3 and 5.6±2.3 days) were not different from PV <100ml (2.7±1.2 and 5.0±2.4 days). In uncatheterised patients (N = 59), post-void residual urine volume (PVR) significantly decreased after surgery in both groups, however, maximum uroflow rate (Qmax) significantly increased after surgery only in PV <100ml but not in PV ≥100ml. Voiding symptoms and patients’ QoL derived from International Prostate Symptom Score (IPSS), IPSS-QoL (IPSS Quality of Life Index) and BPH Impact Index (BII) scores, significantly improved after B-TUVP in both groups. Catheter free status after final B-TUVP among patients with preoperative urinary retention was achieved in 18/24 (75.0%) and 14/17 (82.1%) cases in patient with <100ml and ≥100ml, respectively. There was no significant difference in post-operative Hb after B-TUVP, which was 97.0±5.4% of baseline for PV <100ml and 96.9±6.1% for PV ≥100ml and no TUR syndrome was observed. Conclusions This is the first study investigating short-term efficacy and safety of second-generation B-TUVP with the oval-shaped electrode on large BPE. B-TUVP appears to be effective and safe for treating moderate-to-severe lower urinary tract symptoms and urinary retention in patients with large BPE.

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Holmium Laser Enucleation Versus Bipolar Plasmakinetic Resection for Management of Lower Urinary Tract Symptoms in Patients with Large-Volume Benign Prostatic Hyperplasia: Randomized-Controlled Trial

Cited by 21 publications

References 14 publications

Clinical Efficacy and Quality of Life Assessment of Partial Cystectomy and Plasmakinetic Transurethral Resection of Tumor in Bladder Cancer Patients

Clinical Efficacy and Quality of Life Assessment of Partial Cystectomy and Plasmakinetic Transurethral Resection of Tumor in Bladder Cancer Patients

Holmium laser enucleation versus bipolar resection in the management of large‐volume benign prostatic hyperplasia: A randomized controlled trial

Short-term efficacy and safety of second generation bipolar transurethral vaporization of the prostate (B-TUVP) for large benign prostate enlargement: Results from a retrospective feasibility study

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