Category: BPH/LUTS: Electrosurgery, Lasers & Other Technology
Introduction & Objective :
To study the functional and clinical outcome of patients undergoing a holmium laser transurethral enucleation of the prostate 100 W (HoLEP 100W ) and HoLEP 120 W in a retrospective trial with 12 months of follow-up. Both HoLEP 100W and HoLEP 120W effectively relieve the obstructive symptoms due to benign prostatic hyperplasia (BPH).
We retrospectively collected data from september of 2015 to april of 2017 of 300 patients with BPH who consecutively underwent a endoscopic treatment for BPH performed by a single surgeon with either HoLEP 100W (n = 150) or HoLEP 120W (n =150). An energy setting of 100 W and 120 W was used for the holmium laser in the enucleation procedure, respectively. The Kuntz technique was used and a morcellation to fragment the enucleated lobes was applied.
Mean prostate size were 85.2 and 90.5 cc in HoLEP 100W and 120W respectively. Holep 100 W required a longer operation time (70.4 vs 58.5 minutes, P = 0.03) and resulted in higher blood loss than HoLEP 120W (152.0 vs140.6 mL, P = 0.43). The catheterization time was comparable. In patients treated wit HoLEP 100 W, the International Prostate Symptom Score (IPSS) was 5.2 at 12 months with a preoperative value of 18.5. The International Prostate Symptom Score decreased to 6.2 in the HoLEP 120 W group. With respect to maximum urinary flow rate and quality of life, no differences were found between the 2 groups ( 25.7 vs 27.1 mL/s and 2.3 vs 1.8) and the postvoid residual urine volume decreased by 85.1% and 83.3% in the HoLEP 100 W and HoLEP 120W groups, respectively. The mean prostate-specific antigen dropped from 5.1 to 1.6 ng/ul and from 6.4 to 1.9 ng/ul in both groups respectively. Incidence urethral and bladder neck stricture was comparable in both groups<./p>
Both HoLEP 100 W and 120 W were safe and efficacious to relieve lower urinary tract symptoms in patients with large glans. The effectivness of HoLEP 100W and HoLEP 120W is similar. The blood loss was higher in HoLEP 100W but not statistically significative. Operation time was longer in Holep 100W without affecting the functional and clinical outcomes. The Kuntz technique showed a good adequacy, and the morcellation did not added any statistically significant urethral trauma.
Javier Sanchez Macías– Medical Doctor, Hospital Clinic de Barcelona, Barcelona, Catalonia, Spain
Marco Franco– A.O.U. Federico II University of Naples, Naples, Campania, Italy
Antonio Pardo– , Barcelona, Catalonia, Spain
Ricardo Lombardo– , Rome, Lazio, Italy
Meritxell Costa– resident, Hospital clinic de Barcelona, Barcelona, Catalonia, Spain
Claudia Mercader– resident, Hospital clinic de Barcelona, Barcelona, Catalonia, Spain
Antonio Alcaraz– Full Professor, Barcelona, Catalonia, Spain
Hospital Clinic de Barcelona
Barcelona, Catalonia, Spain