'Top-Down' holmium laser enucleation of the prostate. Report of initial cases performed by a single surgeon.
| Autor: | Hodhod A; Department of Urology, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada., Oquendo F; Department of Urology, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada., Tablowski T; Department of Urology, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada., Abdul-Hadi R; Department of Urology, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada., Shahrour W; Department of Urology, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada., Kotb A; Department of Urology, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada., Prowse O; Department of Urology, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada., Elmansy H; Department of Urology, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada. |
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| Jazyk: | angličtina |
| Zdroj: | Arab journal of urology [Arab J Urol] 2020 Aug 16; Vol. 19 (2), pp. 130-136. Date of Electronic Publication: 2020 Aug 16. |
| DOI: | 10.1080/2090598X.2020.1805964 |
| Abstrakt: | Objectives: To present the 12-month outcomes of 'Top-Down' holmium laser enucleation of the prostate (HoLEP). Patients and Methods: We retrospectively reviewed the charts of prospectively collected patients who underwent Top-Down HoLEP between 2017 and 2018. All cases were operated upon by a single urologist (H.E), using a 100-W holmium:YAG laser with a 550-μm laser fibre. We recorded the enucleation time, morcellation time, intraoperative, and postoperative complications. All patients had postoperative follow-up visits at 1, 3, 6 and 12 months. The evaluation included the International Prostate Symptom Score (IPSS), quality-of-life (QoL) assessment, measurement of maximum urinary flow rate (Q Results: A total of 60 consecutive patients were recruited. The median (range) prostatic volume, resected prostatic weight, and percentage of resected prostatic tissue were 124 (70-266) mL, 90 (44-242) g and 76 (46-97)%, respectively. The median (range) enucleation and morcellation times were 80 (25-200) and 14.5 (4-58) min, respectively. One patient had a simple bladder mucosal injury and another developed clot retention. At 3 months, three patients (5%) had stress urinary incontinence (SUI) and eight patients (13.3%) presented with urge UI (UUI). At the last follow-up visit, one patient (1.7%) presented with persistent SUI, while three patients (5%) presented with UUI. The IPSS and QoL significantly improved during the follow-up period ( P = 0.045 and P = 0.04, respectively). Conclusion: The results of the Top-Down technique are comparable to those of traditional HoLEP. However, the Top-Down technique may reduce the complexity, operating time, and SUI rates. Abbreviations: BN: bladder neck; HoLEP: holmium laser enucleation of the prostate; PVR: post-void residual urine volume; Q Competing Interests: No conflicts of interest to declare. (© 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.) |
| Databáze: | MEDLINE |
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