Assessing the outcome of Holmium Laser Enucleation of the Prostate (HoLEP) by age, prostate volume, and a history of blood thinning agents - report from a single-center series of >1,800 consecutive cases

2020 ◽  
Author(s):  
Philipp Gild ◽  
Lukas Lenke ◽  
Raisa Sinaida Pompe ◽  
Malte Wolfram Vetterlein ◽  
Tim Alexander Ludwig ◽  
...  
Keyword(s):  
Prostate Volume ◽  
Holmium Laser ◽  
Single Center ◽  
History Of ◽  
Laser Enucleation ◽  
Holmium Laser Enucleation

scholarly journals Preoperative predictors of enucleation time during en bloc no-touch holmium laser enucleation of the prostate

2020 ◽  
Author(s):  
Chun-Hsuan Lin ◽  
Ching-Chia Li ◽  
Wen-Jeng Wu ◽  
Sheng-Chen Wen
Keyword(s):  
Operation Time ◽  
Holmium Laser ◽  
En Bloc ◽  
Symptomatic Benign Prostatic Hyperplasia ◽  
Clinical Variables ◽  
Specimen Weight ◽  
History Of ◽  
Laser Enucleation ◽  
Holmium Laser Enucleation ◽  
Preoperative Predictors

Abstract Background To evaluate preoperative predictors of enucleation time during en bloc no-touch holmium laser enucleation of the prostate (HoLEP) Methods We enrolled 135 patients with symptomatic benign prostatic hyperplasia (BPH) treated with en bloc no-touch HoLEP from July 2017 to March 2019 by a single surgeon. Preoperative, perioperative, and postoperative clinical variables were examined. Stepwise linear regression was performed to determine clinical variables associated with enucleation times. Result The average (range) enucleation time was 46.1 (12–220) minutes, and the overall operation time was 71 (18–250) minutes. History of anticoagulation, history of urinary tract infection (UTI), and increasing specimen weight were each significantly associated with increasing enucleation time. No category IV complications were recorded, and all complications were evenly distributed among the groups according to the HoLEP specimen weight. Conclusion En bloc no-touch HoLEP was found to be an efficient and reproducible surgical method for treating BPH. Prostatic gland size was significantly associated with increased enucleation times. Similarly, history of UTI and anticoagulation were correlated with increased operative time.

scholarly journals Holmium laser prostatectomy in a tertiary Italian center: A prospective cost analysis in comparison with bipolar TURP and open prostatectomy

2020 ◽  
Vol 92 (2) ◽  
Author(s):  
Riccardo Schiavina ◽  
Lorenzo Bianchi ◽  
Marco Giampaoli ◽  
Marco Borghesi ◽  
Hussam Dababneh ◽  
...  
Keyword(s):  
Cost Analysis ◽  
Prostate Volume ◽  
Indirect Costs ◽  
Holmium Laser ◽  
Transurethral Resection Of Prostate ◽  
Open Prostatectomy ◽  
Global Cost ◽  
Laser Enucleation ◽  
Holmium Laser Enucleation

Objective: To assess the economic impact of Holmium laser enucleation of prostate (HoLEP) in comparison with transurethral resection of prostate (TURP) and open prostatectomy (OP). Methods: Between January 2017 and January 2018, we prospectively enrolled 151 men who underwent HoLEP, TURP or OP at tertiary Italian center, due to bladder outflow obstruction symptoms. Patients with prostate volume ≤ 70 cc and those with prostate volume > 70 cc were scheduled for TURP or HoLEP and OP or HoLEP, respectively. Intraoperative and early post-operative functional outcomes were recorded up to 6 months follow up. Cost analysis was carried out considering direct costs (operating room [OR] utilization costs, nurse, surgeons and anesthesiologists’ costs, OR disposable products costs and OR products sterilization costs), indirect costs (hospital stay costs and diagnostics costs) and global costs as sum of both direct and indirect plus general costs related to hospitalization. Cost analysis was performed comparing patients referred to TURP and HoLEP with prostate volume ≤ 70 cc and men underwent OP and HoLEP with prostate volume > 70 cc respectively. Results: Overall, 53 (35.1%), 51 (33.7%) and 47 (31.1%) were scheduled to HoLEP, TURP and OP, respectively. Both TURP, HoLEP and OP proved to effectively improve urinary symptoms related to BPE. Considering patients with prostate volume ≤ 70 cc, median global cost of HoLEP was similar to median global cost of TURP (2151.69 € vs. 2185.61 €, respectively; p = 0.61). Considering patients with prostate volume > 70 cc, median global cost of HoLEP was found to be significantly lower than median global cost of OP (2174.15 € vs. 4064.97 €, respectively; p ≤ 0.001). Conclusions: Global costs of HoLEP are comparable to those of TURP, offering a cost saving of only 11.4 € in favor of HoLEP. Conversely, HoLEP proved to be a strong competitor of OP because of significant global cost sparing amounting to 1890.82 € in favor of HoLEP.

Robot-Assisted Radical Prostatectomy in Patients with a History of Holmium Laser Enucleation of the Prostate: Feasibility and Evaluation of Initial Outcomes

2015 ◽  
Vol 29 (7) ◽  
pp. 764-769 ◽  
Author(s):  
Paul T. Gellhaus ◽  
M. Francesca Monn ◽  
Joshua Leese ◽  
Chandra K. Flack ◽  
James E. Lingeman ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Holmium Laser ◽  
Robot Assisted ◽  
History Of ◽  
Laser Enucleation ◽  
Holmium Laser Enucleation

scholarly journals Does Holmium laser enucleation of the prostate (HoLEP) still have a steep learning curve? Our experience of 100 consecutive cases from Turkey

2021 ◽  
Vol 93 (4) ◽  
pp. 412-417
Author(s):  
Güçlü Gürlen ◽  
Kadir Karkin
Keyword(s):  
Learning Curve ◽  
Medical Treatment ◽  
Prostate Volume ◽  
Holmium Laser ◽  
Steep Learning Curve ◽  
First Case ◽  
Laser Enucleation ◽  
The Mean ◽  
Two Parameters ◽  
Holmium Laser Enucleation

Aim: The aim of our study is to examine the learning curve of HoLEP and to discuss our results in the light of the literature. Methods: 100 patients who had LUTS resistant to medical treatment and complicated BPH to whom HoLEP procedure had been administered regardless of the size of the prostate in the last 1 year were analysed retrospectively. To evaluate the learning curve, the patients were classified into 4 main groups of 25 consecutively operated patients beginning from the first case. The 4 main groups were divided into 2 subgroups including patients who had prostate volume below or above 80 grams. Results: The mean age of the 100 patients who had HoLEP was 64.5 years. The mean prostate volume was 99.1 cc (45-281 cc). When those with prostate smaller than 80 g are examined, Enucleation efficiency was 0.76 g/min (0.46-0.97 g/min) and Morcellation efficiency was 3.07 g/min (3.34-4 g/min). When those with prostates larger than 80 g are examined, Enucleation efficiency was 0.89 g/min (0.66-1.04 g/min) and Morcellation efficiency was 4.01 g/min (3.93-4.25 g/min). These two parameters were statistically and significantly different in all the 4 groups (p < 0.05). Conclusions: HoLEP still has a steep learning curve. It is necessary to reach the number of cases of 25-50 to reach fundamental experience.

scholarly journals MP62-17 EIGHTEEN YEARS OF HOLMIUM LASER ENUCLEATION OF THE PROSTATE: A SINGLE CENTER EXPERIENCE

2018 ◽  
Vol 199 (4S) ◽  
Author(s):  
Ahmed Ibrahim ◽  
Mohannad Alharbi ◽  
Mostafa Elhilali ◽  
Serge Carrier
Keyword(s):  
Holmium Laser ◽  
Single Center ◽  
Single Center Experience ◽  
Laser Enucleation ◽  
Holmium Laser Enucleation
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