Stress Incontinence During the Learning Curve of Holmium Laser Enucleation of the Prostate

Lerner, Lori B.; Tyson, Mark D.; Mendoza, Pierre J.

doi:10.1089/end.2010.0021

Cited by 54 publications

(45 citation statements)

References 15 publications

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“…SUI is a frequent topic of focus when considering post-HoLEP UI. Indeed, a previous study defined the postoperative mixed UI and use of a pad as SUI [13]. However, another report described the development of not only de novo SUI, but also de novo UUI after HoLEP [14].…”

Section: Discussionmentioning

confidence: 99%

“…In previous studies, the patient factors associated with post-HoLEP UI included the (predicted) enucleated tissue weight, DM, and a high PSA reduction rate [12]; the medical factors included the operator's surgical proficiency level [13] and bladder mucosal injury [14] at the time of surgery. However, no consensus has been reached regarding these factors.…”

Section: Discussionmentioning

confidence: 99%

“…Continued UI after prostate surgery has been reported to deteriorate a patient's health-related quality of life (QOL), as measured by instruments such as the EuroQOL-5 Dimension and Short Form 12-Item Survey [11]; accordingly, UI after HoLEP is thought to similarly influence the health-related QOL. Some reports have described the preoperative prognosticators of post-HoLEP UI [12,13,14] and have devised procedures to prevent this complication [15]. However, it is challenging to address this issue because many patients are poorly compliant after surgery (i.e., do not regularly visit hospitals); additionally, no sufficient evaluation method has been established because of the lack of a clear and unified standard, in contrast to the post-surgical follow-up procedures for cases involving malignant diseases such as prostate cancer.…”

Section: Introductionmentioning

confidence: 99%

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Practical Index of Urinary Incontinence Following Holmium Laser Enucleation of the Prostate: A Case-Series Study of the 24-Hour Pad Test Immediately after Catheter Removal

Fujisaki

Goto²,

Endo³

et al. 2016

Urol Int

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Introduction: Epidemiological data regarding complications after holmium laser enucleation of the prostate (HoLEP) are scarce in Japan. We examined the associations of the 24-hour pad test results immediately after HoLEP with continence acquisition at 3 months postoperatively. Materials and Methods: In this hospital-based case-series study, we reviewed medical charts of 341 patients without catheterization and 150 patients with catheterization at the time of surgery. The 24-hour pad test was conducted immediately after catheter removal to measure the leakage weight. Subjects were divided into 2 groups: leakage weight = 0 g (negative) and >0 g (positive). Urinary incontinence (UI) at 3 months postoperatively was self-reported by patients. Results: Significant relationships were observed between pad test positivity and UI at 3 months postoperatively and between the pad test weight and the timing of continence acquisition in patients with and without catheterization. In multivariate analyses, the pad test positivity was associated significantly with the Overactive Bladder Symptom Score and enucleated tissue weight in patients without perioperative catheterization and with age in patients with catheterization. Conclusions: The 24-hour pad test immediately after catheter removal could indicate the need for early and active intervention to prevent continuous postoperative UI. Patients' symptoms and clinical items predictive of test positivity should be carefully assessed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Practical Index of Urinary Incontinence Following Holmium Laser Enucleation of the Prostate: A Case-Series Study of the 24-Hour Pad Test Immediately after Catheter Removal

Fujisaki

Goto²,

Endo³

et al. 2016

Urol Int

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show abstract

“…In their experience, the more frequently HoLEP was performed during the learning curve, the lower the incidence of SUI [Lerner et al 2010].…”

Section: Bipolar-turp (B-turp)mentioning

confidence: 99%

Holmium laser enucleation of the prostate: a paradigm shift in benign prostatic hyperplasia surgery

Aho

2013

Therapeutic Advances in Urology

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Holmium laser enucleation (HoLEP) was developed in the 1990s as a more efficient and cost effective method of benign prostatic hyperplasia surgery than laser vaporization and resection techniques. As a true anatomical enucleation it mimics open prostatectomy and is as durable. There is a significant body of level 1 evidence in support of HoLEP, including 2 metaanalyses and 14 randomized trials which compare HoLEP with a number of other procedures. This review describes the development of and summarizes the evidence for HoLEP.

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“…It seems apparent that voiding complications decrease not only with case volume, but also with regular performance of HoLEP early in the learning curve [19]. This suggests that when first learning HoLEP, practitioners should attempt to schedule patients within short intervals (ideally no longer than 2 weeks between procedures) and not allow significant time to accrue between each case, thus permitting the surgeon to refine his or her skills and maximize the learning benefit provided by repetition.…”

Section: Holmium Laser Enucleation Of the Prostate Complicationsmentioning

confidence: 99%

Holmium Laser Approaches to Symptomatic Benign Prostatic Hyperplasia

Boylan

Lerner

2011

Curr Bladder Dysfunct Rep

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The holmium laser is a well-established instrument in the treatment of a variety of urologic conditions. Treatment of benign prostatic hyperplasia (BPH) with the holmium laser has grown steadily over the past decade, with multiple studies demonstrating its role as an effective alternative to other transurethral and open surgical treatments of BPH. This review describes current surgical techniques that employ the holmium laser and surveys recent literature comparing holmium-based treatments with traditional transurethral techniques, with particular attention paid to holmium laser enucleation of the prostate. Recent studies continue to support the short-and long-term efficacy of holmium laser enucleation of the prostate and other holmium-based treatments, providing evidence for the laser's growing use in the treatment of benign obstruction. Transurethral surgery with the holmium laser endures as an effectual treatment for BPH that offers excellent, lasting functional outcomes with favorable short-and long-term morbidity when compared with conventional transurethral techniques.

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Stress Incontinence During the Learning Curve of Holmium Laser Enucleation of the Prostate

Abstract: The major associated risk for SUI, a complication presumably related to surgical technique, was prolonged duration between cases. During the learning curve, surgeons should schedule patients frequently to enhance learning and decrease time to mastery of the technique, thereby reducing SUI.

Cited by 54 publications

References 15 publications

Practical Index of Urinary Incontinence Following Holmium Laser Enucleation of the Prostate: A Case-Series Study of the 24-Hour Pad Test Immediately after Catheter Removal

Practical Index of Urinary Incontinence Following Holmium Laser Enucleation of the Prostate: A Case-Series Study of the 24-Hour Pad Test Immediately after Catheter Removal

Holmium laser enucleation of the prostate: a paradigm shift in benign prostatic hyperplasia surgery

Holmium Laser Approaches to Symptomatic Benign Prostatic Hyperplasia

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