Category: Other, Miscellaneous

VS15-5 - Holmium laser enucleation of the prostate (HoLEP) for patients with advanced prostate cancer

Sun, Sep 23
10:00 AM - 12:00 PM

Introduction & Objective :

To report the initial experience and outcome of holmium laser enucleation of the prostate (HoLEP) in treating advanced prostate cancer.


Methods :

A total of 21 patients with advanced prostate cancer who underwent HoLEP from June 2016 to December 2017 in The First Affiliated Hospital of Nanjing Medical University were included in this study. The mean prostate specific antigen (PSA) level was 595ng/ml. All patients underwent imaging examination, which confirmed the presence of local invasion and/or bone metastases. All patients had obvious lower urinary tract symptoms before operation, such as frequent micturition, dysuria, hematuria and nocturnal inuresis.  Resection was began at the level proximal to the verumontanum. After performing the initial resection, an anatomic plane was formed between the surgical capsule and adenoma. Using the shaft of the resectoscope and laser impulse, the plane was developed until the bladder neck. The same method was used for the lateral and middle lobes. Carefully avoiding the penetration of the bladder neck at 5–7 o’clock position. After the resection, all the lobes dropped into the bladder. A morcellator with an offset nephroscopic lens was introduced, and the tissue shivers were removed by irrigation. Endocrine therapy began after the diagnosis of pathology. Clinical data before and 3 months after the surgery were analyzed.


Results :

HoLEP were technically successful in all 21 patients. The mean total operative time were 42.3(35~165)min; and mean resected prostate weight was 40 (10~76)g. No transurethral resection syndrome was observed during and after HoLEP. The estimated blood loss during HoLEP was 62.1 ± 23.7 mL, and no case required transfusion. International Prostate Symptom Score and postvoid residual volume significantly decreased (24.1 ± 2.84 vs 13.5 ± 3.39, P <0.001; 67.1 ± 30.8 vs 20.8 ± 8.8, P <0.001, respectively), maximal flow rate significantly increased (7.25 ± 1.42 vs 19.63 ± 16.56, P <0.001). The PSA level decrease to 5ng/ml three month after surgery. 


Conclusions :

HoLEP as a palliative surgery in treating advanced prostate cancer is safe and effective, it can achieve good symptoms improvement and tumor reduction.

xiaoxin meng

Chief physician
First Affiliated Hospital of Nanjing Medical University
Nanjing, Jiangsu, China (People's Republic)

Xiaoxin Meng, male, 46 years old, MD,chief physician. Research direction: surgical treatment of benign prostatic hyperplasia, diagnosis and treatment of pelvic floor disease and urinary incontinence.

Pu Li

associate chief physician
First Affiliated Hospital of Nanjing Medical University
Nanjing, Jiangsu, China (People's Republic)

Pu Li, Male, 35years old, MD, associate chief physician of urology. Research direction: surgical treatment of benign prostatic hyperplasia, diagnosis and treatment of urinary incontinence and pelvic floor disease.