Klinik, Diagnostik und Therapie des benignen Prostatasyndroms

Tamalunas, Alexander; Magistro, Giuseppe; Grimm, Tobias; Jokisch, Jan-Friedrich; Westhofen, Thilo; Schott, Melanie; Stief, Christian G.; Weinhold, Philipp

doi:10.1007/s15006-019-0017-7

Cited by 2 publications

References 32 publications

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Efficacy, efficiency, and safety of en-bloc vs. three-lobe enucleation of the prostate: a propensity score-matched analysis

Tamalunas,

Schott,

Keller

et al. 2024

Advanced Photonics in Urology 2024

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Objective: To assess efficacy, efficiency, and safety in holmium laser enucleation of the prostate (HoLEP), we directly compared intraoperative performance, postoperative outcomes, and safety in the original three-lobe enucleation technique with the more recent en-bloc method.Methods: Retrospective, propensity score-matched analysis of 606 men who underwent HoLEP for LUTS/BPO. Patients were stratified by technique, and groups were compared for perioperative parameters, safety, and short-term functional outcomes.Results: While postoperative symptoms and urodynamic parameters improved irrespective of technique, we report significantly less adverse events (Clavien-Dindo classification >/=II vs < II) for patients receiving en-bloc enucleation. Additionally, en-bloc enucleation was more efficient i.e., less than half of total laser energy (kJ), twice shorter enucleation time, and surgical performance (g/kJ/min) significantly increased 4-fold with prostate volume, compared to three-lobe enucleation.Significance: While HoLEP in general is a safe and effective procedure, en-bloc enucleation techniques offer better surgical performance.

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Efficacy, efficiency, and safety of en-bloc vs. three-lobe enucleation of the prostate: a propensity score-matched analysis

Tamalunas,

Schott,

Keller

et al. 2024

Advanced Photonics in Urology 2024

Self Cite

View full text Add to dashboard Cite

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How does symptom severity impact clinical outcomes of men with lower urinary tract symptoms after holmium laser enucleation or transurethral resection of the prostate?

Tamalunas

Schott

Keller

et al. 2022

Cent european J Urol

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Introduction International Prostate Symptom Score (IPSS) is a validated outcome measure for the evaluation of patients with lower urinary tract symptoms (LUTS) secondary to benign prostatic obstruction (BPO). When treating patients with transurethral resection of the prostate (TURP) or holmium laser enucleation of the prostate (HoLEP), patient selection is key to achieve the best clinical outcome. Therefore, we analyzed how the severity of LUTS as determined by IPSS influenced postoperative functional outcomes. Material and methods We conducted a retrospective, matched-pair analysis of 2,011 men who underwent HoLEP or TURP for LUTS/BPO between 2013–2017. We included 195 patients in the final analysis (HoLEP n = 97; TURP n = 98), who were matched for prostate size (50 cc), age, and body mass index. Patients were then stratified by IPSS. Groups were compared for perioperative parameters, safety and short-term functional outcomes. Results While preoperative symptom severity was a significant predictor of postoperative clinical improvement, patients who received HoLEP showed superior postoperative functional results with higher peak flow rates and 2-fold greater improvement in IPSS. In patients presenting with severe symptoms, we observed 3- to 4-fold less Clavien-Dindo grade ≥II and overall complications after receiving HoLEP compared to TURP. Conclusions Patients with severe LUTS were more likely to experience clinically significant improvement after surgery than patients with moderate LUTS, and HoLEP showed superior functional outcomes than TURP. However, patients with moderate LUTS should not be denied surgery, but may warrant a more comprehensive clinical work-up.

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Klinik, Diagnostik und Therapie des benignen Prostatasyndroms

Cited by 2 publications

References 32 publications

Efficacy, efficiency, and safety of en-bloc vs. three-lobe enucleation of the prostate: a propensity score-matched analysis

Efficacy, efficiency, and safety of en-bloc vs. three-lobe enucleation of the prostate: a propensity score-matched analysis

How does symptom severity impact clinical outcomes of men with lower urinary tract symptoms after holmium laser enucleation or transurethral resection of the prostate?

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