Meta-analysis of Functional Outcomes and Complications Following Transurethral Procedures for Lower Urinary Tract Symptoms Resulting from Benign Prostatic Enlargement

Ahyai, Sascha; Gilling, Peter; Kaplan, Steven A.; Kuntz, Rainer M.; Madersbacher, Stephan; Montorsi, Francesco; Speakman, Mark; Stief, Christian G.

doi:10.1016/j.eururo.2010.06.005

Cited by 567 publications

(439 citation statements)

References 75 publications

Supporting

Mentioning

366

Contrasting

Unclassified

Order By: Relevance

“…Considerable level one evidence has demonstrated the benefits of HoLEP over simple prostatectomy and TURP for the treatment of BPH in large glands [8][9][10][11][12][13][14] . Amongst established benefits of HoLEP are its long term, durable, and reproducible results that can be applied to any prostate gland size 12,15,16 Enucleation involves complete removal of the transitional zone of the prostate using a holmium-YAG laser.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Predictors of Enucleation and Morcellation Time During Holmium Laser Enucleation of the Prostate

Monn

Tayeb

Bhojani

et al. 2015

Urology

View full text Add to dashboard Cite

Objectives: To examine predictors of enucleation and morcellation time within a large cohort of men undergoing HoLEP for benign prostatic hypertrophy.Methods: Pre-operative, peri-operative, and post-operative clinical characteristics were available from men treated with HoLEP between 1998 and 2013 at Indiana University Health Methodist Hospital. Stepwise linear regression was performed to determine clinical variables which are associated with enucleation and morcellation times. Results:We identified 960 patients who underwent HoLEP. Average (range) enucleation time was 65.7 (11-245) minutes and morcellation time was 19.7 (3-260) minutes. History of anticoagulation was associated with a small decrease in enucleation time (p=0.013) while increasing HoLEP specimen weight was associated with increasing enucleation time (p<0.001).History of intermittent catheterization, urinary tract infections, presence of dense prostatic tissue (colloquially referred to as "beach balls"), and increasing specimen weight were associated with increasing morcellation time (p<0.05 each). Having HoLEP performed by a less experienced urologist was associated with longer enucleation and morcellation times. Conclusions:Prostate volume is significantly associated with increased enucleation and morcellation times during HoLEP. Additionally, history of UTI and CIC are associated with modest increases in enucleation and morcellation times. Dense enucleated prostate tissue significantly impacts the ability to morcellate effectively. Increasing surgeon experience can significantly improve both enucleation and morcellation efficiency.3

show abstract

Section: Discussionmentioning

confidence: 99%

“…Amongst established benefits of HoLEP are its long term, durable, and reproducible results that can be applied to any prostate gland size 12,15,16 Enucleation involves complete removal of the transitional zone of the prostate using a holmium-YAG laser. This is not a vaporization procedure but rather the laser is used as a cutting tool.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Enucleation and Morcellation Time During Holmium Laser Enucleation of the Prostate

Monn

Tayeb

Bhojani

et al. 2015

Urology

View full text Add to dashboard Cite

show abstract

“…Although effective, the technique can be associated with significant complications, including TUR syndrome and bleeding [3][4][5][6]. Newer technologies such as PVP offer safer and equally effective alternatives to relieve symptomatic bladder outlet obstruction [7][8][9][10][11][12][13][14][15]. Few studies however have directly examined the clinical differences between 80 W vs. 120 W PVP [17].…”

Section: Discussionmentioning

confidence: 99%

“…This technique has been shown to result in comparatively fewer complications, e.g. reduced incidence of TUR syndrome as well as bleeding [7][8][9][10][11][12][13][14][15], Improvements to the Greenlight ™ laser system have been made over time, particularly with the introduction of the 120 W HPS system in 2006. Few however have compared the clinical performance of the newer systems with their predecessors.…”

Section: Introductionmentioning

confidence: 99%

Comparison of 80 W versus 120 W 532 nm Laser Prostatectomy for BPH

Lee¹

2013

OJU

View full text Add to dashboard Cite

Purpose: Improvements to photoselective vaporization of the prostate (PVP) have been made over time, particularly with the introduction of higher power systems. Few studies however have compared the performance of these systems to their predecessors. Baseline parameters were similar between the two groups except for greater median age (72.8 vs. 69.2 years, p = 0.01) and lower median PSA (2.0 vs. 3.3, p = 0.01) in the 80 W group. Median laser time was longer in the 80W group (85 vs. 51 minutes, p < 0.001) with a higher median energy utilized (253 vs. 210 kJ, p = 0.001). Final IPSS, Qmax, PVR, and PSA were equivalent between the two groups. Conclusions: In our series, PVP was safe and effective. Durable and similar improvements in symptoms and objective parameters were achieved in patients with both 80 W and 120 W laser systems. PVP with the 120 W system, however, provided faster and more efficient vaporization compared to the 80 W system.

show abstract

“…Yakın zamanda yapılan ve maksimum 5 yıllık takiplerin sunulduğu 20 randomize kontrollü çalışmanın dahil edildiği metaanalizin sonuçlarına göre TURP sonrası semptom skorundaki azalma oranı %70 olarak bulunurken, maksimum akım hızında ise %162'lik artış saptanmıştır. Ayrıca yaşam kalitesinde % 69 iyileşme ve postvoiding rezidüel idrarda %77 azalma izlenmiştir [10]. Uzun dönem takiplerde de bu etkinliğin devam ettiği gösterilmiştir [11].…”

Section: Etkinlikunclassified

Transurethral Prostate Resection Techniques

2015

Indications and Resection Methods of Prostate

View full text Add to dashboard Cite

GirişBenign prostat hiperplazisine (BPH) bağlı mesane çıkım obstrüksiyonu yaşlanan erkeklerde en sık karşılaşılan ürolojik patolojilerdendir. Böbrek yetmezliği gibi nadir rastlanan komplikasyonlar dışında yaşamı tehdit eden bir durum yaratmasa da, yaşam kalitesi üzerine ciddi olumsuz etkileri olmaktadır. Günümüzde birçok medikal tedavi seçeneği mevcuttur. Bunun dışında medikal tedaviden fayda görmeyen orta ve şiddetli derecede semptomları olan hastalara cerrahi tedavi önerilmektedir. Son yıl-larda çeşitli yeni minimal invaziv tedaviler popüler olsa da, transüretral prostat rezeksiyonu (TURP), bugün için halen BPH tedavisinde altın standart tedavi olarak kabul edilmektedir. Transüretral prostat rezeksiyonu için birçok cerrahi teknik tanımlanmıştır. Rezeksiyon tekniği prostat boyutu ve konfigürasyonuna göre değişebilse de rezeksiyonun rutin ve adım-adım gerçekleştirilmesi vazgeçilmez ilkedir. Bu yazımızda en sık kullanı-lan transüretral prostat rezeksiyon teknikleri anlatılmıştır. Rezeksiyon Yöntemleriİşlem öncelikle sistoüretroskopik olarak üretra ve mesanenin dikkatli bir şekilde endoskopik olarak gözlenmesi ile başlar. Rezeksiyona başlamadan önce oryantasyonu sağlayacak olan üreter orifisleri, mesane boynu, prostatik üretra, verumontanum (kollikulus seminalis) ve external üretral sfinkter tanımlanır. Genellikle bu yapıların tanımlanması kolaydır. Ancak rezeksiyon sırasında ortaya çıkan mesane boynundaki internal sfinkter, adenom dokusu, prostatın cerrahi kapsülü, prostat taşları ve vaskü-ler yapılar gibi oryantasyon noktalarının tanınması ise deneyim gerektirir. Verumontanum, rezeksiyonun distal sınırını belirlemede en önemli noktadır. Rezektoskop verumontanumdan dışarı doğru çekildiğinde görüş alanını dolduran ileriye

show abstract

Meta-analysis of Functional Outcomes and Complications Following Transurethral Procedures for Lower Urinary Tract Symptoms Resulting from Benign Prostatic Enlargement

Cited by 567 publications

References 75 publications

Predictors of Enucleation and Morcellation Time During Holmium Laser Enucleation of the Prostate

Predictors of Enucleation and Morcellation Time During Holmium Laser Enucleation of the Prostate

Comparison of 80 W versus 120 W 532 nm Laser Prostatectomy for BPH

Transurethral Prostate Resection Techniques

Contact Info

Product

Resources

About