Holmium: YAG Laser Incision of Bladder Neck Contracture Following Radical Retropubic Prostatectomy

Karkan, Morteza Fallah; Razzaghi, Mohammad Reza; Javanmard, Babak; Tayyebiazar, Ali; Ghiasy, Saleh; Montazeri, Saeed

doi:10.5812/numonthly.88677

Cited by 5 publications

(5 citation statements)

References 23 publications

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“…Today, the laser has an excellent application in urologic diseases. [22][23][24] Endoscopic laser lithotripsy (LL) is frequently used to manage patients with urolithiasis. 8,25 A number of lasers have been used for LL, of which the Ho:YAG has become one of the most frequently used one.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Stone Retrieval Basket, Stone Cone and Holmium Laser: Which One Is Better in Retropulsion and Stone-Free Status for Patients with Upper Ureteral Calculi?

et al. 2019

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Introduction: Transurethral lithotripsy (TUL) is an appropriate treatment for ureteral stones and is usually used for stones in the middle and lower part of the ureter. Different devices such as the Holmium laser, the stone basket, and the stone cone exist to prevent any fragments from retropulsion during TUL. The present study aims to compare the advantages and disadvantages of the Holmium laser, the stone basket, and the stone cone. Methods: A retrospective study was conducted from September 2016 to January 2018 comparing various TUL methods in 88 subjects with proximal ureteral calculi. The study participants were divided into 4 matched groups. The first one included 20 patients undergoing TUL with no device (group 1), the second group included 22 patients undergoing TUL while using the stone retrieval basket, the third group included 18 patients undergoing TUL while utilizing the stone cone and the fourth group included 28 patients undergoing TUL while using the Hol-YAG laser. Results: A residual stone ≥3 mm was recorded in 15.9% of the patients. The stone free rate was seen in 100%, 90.9, 83.3%, and 55% of the Holmium laser group, the retrieval basket group, the stone cone group and the no device group respectively (P=0.001). The lowest rate of surgery complications including ureteral perforation, post-operative fever, and mucosal damage between the 4 groups (P=0.003) and the highest time of surgery (P=0.001) belonged to the laser group. If we want to ignore the laser group, the success rate for lithotripsy was better in both groups with a stone retrieval device compared to the no device group, but no advantage existed between the stone basket and the stone cone. Conclusion: We can safely conclude that lasers significantly help to prevent stone migration during TUL. If we want to ignore the laser group, the success rate for lithotripsy was significantly better in both groups with a stone retrieval device compared to the no device group, but no advantage existed between the stone basket and the stone cone.

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Section: Discussionmentioning

confidence: 99%

Comparison of Stone Retrieval Basket, Stone Cone and Holmium Laser: Which One Is Better in Retropulsion and Stone-Free Status for Patients with Upper Ureteral Calculi?

et al. 2019

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“…13 RP should be recommended in patients with a long life expectancy, poorly differentiated tumors or high PSA levels after TURP. 33,34 RP provides ten-year biochemicalfree survival rates as high as 79-98% and 74-88% in T1a and T1b cases, respectively. 12,35,36,37 Matanhelia et al showed that curative treatments need to be considered for younger cases with a long life expectancy or patients with higher-risk disease.…”

Section: Treatmentsmentioning

confidence: 99%

<p>The Management of Patients Diagnosed with Incidental Prostate Cancer: Narrative Review</p>

Abedi

Ghiasy

Fallah-Karkan

et al. 2020

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5-14% of patients underwent surgery for benign prostate hyperplasia harboring prostate cancer (PCa) focus. The best management of incidental prostate cancer (iPCa) has been debated. The decision "treatment or no treatment" should be determined by predictors which accurately foretell PCa progression after transurethral resection of the prostate (TURP). The purpose of this study is to review the available data that can be useful in daily clinical judgment. Transrectal ultrasound prostate biopsy (TRUSBx) did not provide further Gleason score (GS) data in most patients diagnosed with iPCa. TRUSBX may be useful before active surveillance, but not in all following radical prostatectomy. The decision "treatment or no treatment" should be dependent on the expected chance of having residual cancer and clinical progression. Prostate-specific antigen (PSA) levels before and after TURP are good predictors of residual cancer after TURP. Pathological report of T0 is most likely seen in patients with low PSA density after TURP and indistinguishable lesion on multiparametric magnetic resonance imaging. The decision "treatment vs no treatment" is judged by life expectancy, tumor characteristic in the pathology report of TURP sample and PSA level following TURP. Active surveillance should be contemplated in patients with iPCa who have both prostate-specific antigen density ≤0.08 after TURP and indistinguishable cancer lesion on multiparametric magnetic resonance imaging. Patients who do not meet the criteria for active surveillance are candidates for radical prostatectomy or radiotherapy (RT). Radical prostatectomy could be peacefully done after TURP with somewhat greater morbidity. RT in patients who had a history of TURP could be safely done and is associated with acceptable quality of life.

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“…9 The Holmium laser has a good penetration depth, which helps in staunching blood; it is also used for other urologic surgeries, including urolithiasis, 10,11 bladder tumor, 6 genital skin lesion, 12 and urethrotomy. 13,14 The Holmium laser enucleation of the prostate (HoLEP) was introduced about 20 years ago as a surgical treatment for the lower urinary tract symptom (LUTS) resulting from BPH. 15 Despite some drawbacks such as a special equipment requirement and a steep learning curve, it seems that HoLEP is an efficient surgical approach to BPH.…”

Section: Introductionmentioning

confidence: 99%

Is Holmium Laser Enucleation of the Prostate a Good Surgical Alternative in Benign Prostatic Hyperplasia Management? A Review Article

et al. 2020

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Several therapeutic approaches such as holmium laser enucleation of the prostate (HoLEP) have been introduced to relieve bladder outlet obstruction caused by benign prostatic hyperplasia (BPH). Compared with other techniques including the transurethral resection of the prostate (TURP) and simple open prostatectomy, HoLEP results in a shorter hospital stay and catheterization time and fewer blood loss and transfusions. HoLEP is a size-independent treatment option for BPH with average gland size from 36 g to 170 g. HoLEP is a safe procedure in patients receiving an anticoagulant and has no significant influence on the hemoglobin level. Also, HoLEP is an easy and safe technique in patients with a prior history of prostate surgery and a need for retreatment because of adenoma regrowth. The postoperative erectile dysfunction rate of patients treated with HoLEP is similar to TURP or open prostatectomy and about 77% of these patients experience loss of ejaculation. Patients with transitional zone volume less than 30 mL may suffer from persistent stress urinary incontinence following HoLEP so other surgical techniques like bipolar TURP are a good choice for these patients. In young patients, considering HoLEP with high prostate-specific antigen density and a negative standard template prostate biopsy, multiparametric MRI needs to be considered to exclude prostate cancer.

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Holmium: YAG Laser Incision of Bladder Neck Contracture Following Radical Retropubic Prostatectomy

Cited by 5 publications

References 23 publications

Comparison of Stone Retrieval Basket, Stone Cone and Holmium Laser: Which One Is Better in Retropulsion and Stone-Free Status for Patients with Upper Ureteral Calculi?

Comparison of Stone Retrieval Basket, Stone Cone and Holmium Laser: Which One Is Better in Retropulsion and Stone-Free Status for Patients with Upper Ureteral Calculi?

<p>The Management of Patients Diagnosed with Incidental Prostate Cancer: Narrative Review</p>

Is Holmium Laser Enucleation of the Prostate a Good Surgical Alternative in Benign Prostatic Hyperplasia Management? A Review Article

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