The “Omega Sign”: a novel HoLEP technique that improves continence outcomes after enucleation

Tunç, Lütfi; Yalçın, Serdar; Kaya, Engin; Gazel, Eymen; Yılmaz, Sercan; Aybal, Halil Çağrı; Yılmaz, Mehmet Emin; Tokas, Theodoros

doi:10.1007/s00345-020-03152-9

Cited by 41 publications

(23 citation statements)

References 29 publications

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“…Under regional or general anaesthesia, Omega Sign HoLEP technique that previously described by our team was performed in all procedures (Tunc et al., 2020). Two‐pedal 120 W Holmium: YAG Laser (VersaPulse; Lumenis Ltd.) with 550‐µm end‐firing fibre (SlimLine TM 550, Lumenis Inc.) was used as energy source.…”

Section: Methodsmentioning

confidence: 99%

Comparison of outcomes of Holmium enucleation of the prostate for small‐ and moderate‐sized prostates

Yılmaz¹,

Yalçın²,

Yılmaz

et al. 2021

Andrologia

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There is an ongoing discussion in the literature on the surgical treatment option for small prostate size benign prostate hyperplasia (BPH) patients. This study aimed to evaluate the efficacy of Holmium laser enucleation of the prostate (HoLEP) surgery in small (<30 ml) and moderate (30–80 ml) prostate size as accepted in European Association of Urology guideline. We retrospectively analysed our database between May 2016 and May 2019 and patients who underwent HoLEP surgery. Patients who have prostate size <80 ml were included the study. These patients were divided into two group: group 1 with prostate size <30 ml (n: 64) and group 2 with prostate size 30–80 ml (n: 101). Enucleation time (ET), morcellation time (MT), total operation time (OT), enucleation efficiency (EE), morcellation efficiency (ME), intra‐ and post‐operative complications were analysed. While EE and Hb drop were better in favour of group 2; PSA drop, ET, MT, OT and ME were superior in favour of group 1. In group 1, intra‐operative complications were higher (6 vs. 2; p < .05) and post‐operative complications did not differ statistically between groups (p = .14). No statistically significant finding was found between groups regarding incontinence. In conclusion, HoLEP is a reliable method in terms of its results in patients with small prostates.

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Section: Methodsmentioning

confidence: 99%

Comparison of outcomes of Holmium enucleation of the prostate for small‐ and moderate‐sized prostates

Yılmaz¹,

Yalçın²,

Yılmaz

et al. 2021

Andrologia

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“…Furthermore, there is recent evidence in the literature to suggest that the EBT decreases the rates of stress urinary incontinence. 15 There are limitations to our study. First, this was a retrospective comparison between the EBT and LT.…”

Section: F I G U R E 1 Illustration Depicting the Steps Undertaken In The En Bloc Technique 4 | Discussionmentioning

confidence: 89%

En bloc enucleation technique during holmium laser enucleation of the prostate: An analysis of its efficiency

Whiting

Penev

Ijaaz

et al. 2021

LUTS

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Objective: Despite the acknowledgment that holmium laser enucleation of the prostate (HoLEP) is a safe, efficacious procedure with benefits over traditional treatments, it is not widely adopted. Its steep learning curve is considered responsible, and the new en bloc technique (EBT) aims to improve this. Methods: A retrospective analysis of 268 consecutive patients (215 lobe technique [LT] and 53 EBT) who underwent HoLEP between May 2016 and April 2020 was performed. Data were collected on patient demographics, prostate volume, enucleation time, prostatic weight, and length of stay.Results: There was no difference in mean prostate volume and enucleated prostatic weight between the LT and EBT (99.2 mL vs 98.5 mL, P = .95216, and 71.7 g vs 69.3 g, P = .92034, respectively). There was a reduction in mean enucleation time with the EBT to 37.7 minutes compared with 53.3 minutes (LT) (P < .00001). This translated to an improved operative efficiency of 1.84 g/min (EBT) compared to 1.33 g/min (LT) (P < .00001). The EBT demonstrated a continuous improvement in operative efficiency with increasing prostate size unlike the LT where efficiency plateaus. Conclusions:The EBT for HoLEP demonstrates a significant improvement in operative efficiency which has the potential to reduce the surgeons' learning curve and lead to more widespread adoption.

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“…All procedures were performed by a single surgeon (LT) using the previously described ‘Omega Sign’ technique, under regional or general anaesthesia (Tunc et al., 2020). A 26‐Fr continuous flow resectoscope was used in both groups.…”

Section: Methodsmentioning

confidence: 99%

Laser enucleation for prostates larger than 100 mL: Comparison of HoLEP and ThuLEP

et al. 2021

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Summary Recently, with the advancements in laser technology, Holmium laser enucleation of the prostate (HoLEP) and Thulium laser enucleation of the prostate (ThuLEP) have come to the fore in the surgical treatment of benign prostatic hyperplasia (BPH). We aimed to evaluate and compare the outcomes of HoLEP and ThuLEP in patients with >100 ml prostate volume. Patients who underwent HoLEP and ThuLEP between July 2017 and March 2020 were reviewed retrospectively. The patients were divided into two groups as HoLEP (Group 1, n = 121) and ThuLEP (Group 2, n = 104). Perioperative parameters, functional outcomes, continence status, intra and post‐operative complications were compared between groups in the post‐operative 1st and 6th month. No significant difference was found in terms of total laser energy (TLE), morcellation efficiency (ME), enucleated tissue weight (ETW), complication rates (CR) and continence status of patients between both groups (p > .05). In favour of ThuLEP group, there were statistically significant differences regarding total operation time (TOT), laser efficiency (LE), enucleation time (ET) and enucleation efficiency (EE) between groups (p ≤ .05). HoLEP and ThuLEP can be used safely and effectively in prostates larger than 100 ml.

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The “Omega Sign”: a novel HoLEP technique that improves continence outcomes after enucleation

Cited by 41 publications

References 29 publications

Comparison of outcomes of Holmium enucleation of the prostate for small‐ and moderate‐sized prostates

Comparison of outcomes of Holmium enucleation of the prostate for small‐ and moderate‐sized prostates

En bloc enucleation technique during holmium laser enucleation of the prostate: An analysis of its efficiency

Laser enucleation for prostates larger than 100 mL: Comparison of HoLEP and ThuLEP

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