Abstract
Introduction: To compare the prostate removal speeds of 3 enucleation techniques and to evaluate how the operating times change depending on the prostate volume. Methods: Medical records of patients with 80-g or larger prostates who underwent holmium laser enucleation of the prostate (HoLEP), laparoscopic simple prostatectomy (LSP), or open prostatectomy (OP) due to medical treatment-resistant benign prostatic hyperplasia (BPH) were reviewed retrospectively. Patients were classified into 3 groups according to the surgical procedure. Age, BMI, prostate weights, total operation times, prostate removal speeds, hospitalization and catheterization days, complications, and improvements on functional outcomes in the 3rd month of follow-up were compared between groups. In addition, the association between prostate weight and total operation time was analyzed for each group. Results: HoLEP, LSP, and OP groups consisted of 60, 61, and 37 patients, respectively. While HoLEP was similar to OP in terms of prostate removal speed and total operation time, LSP was statistically slower and required more operation time than HoLEP and OP. There was a relationship between prostate weight and total operation time only in HoLEP. Conclusion: LSP, one of the enucleation techniques in the treatment of large prostates, was slower and required more operation time than HoLEP and OP in terms of total operation time and prostate removal speed. HoLEP seems going to be the fastest candidate for the rapid removal of large prostates in the future.
References
1.
Kim
JH
, Park
JY
, Shim
JS
, Lee
JG
, Moon
DG
, Yoo
JW
, et al. Comparison of outpatient versus inpatient transurethral prostate resection for benign prostatic hyperplasia: comparative, prospective bi-centre study
. Can Urol Assoc J
. 2014 Jan–Feb
;8
(1–2
):E30
–5
. .2.
Gravas
S
, Cornu
JN
, Gacci
M
, Gratzke
C
, Herrmann
TRW
, Mamoulakis
C
, et al. EAU guidelines on management of non-neurogenic male lower urinary tract symptoms (LUTS), incl. benign prostatic obstruction (BPO)
. 2019
.3.
Juaneda
R
, Thanigasalam
R
, Rizk
J
, Perrot
E
, Theveniaud
PE
, Baumert
H
. Holmium laser enucleation versus laparoscopic simple prostatectomy for large adenomas
. Actas Urol Esp
. 2016 Jan–Feb
;40
(1
):43
–8
. .4.
Naspro
R
, Suardi
N
, Salonia
A
, Scattoni
V
, Guazzoni
G
, Colombo
R
, et al. Holmium laser enucleation of the prostate versus open prostatectomy for prostates >70 g: 24-month follow-up
. Eur Urol
. 2006 Sep
;50
(3
):563
–8
.5.
Salonia
A
, Suardi
N
, Naspro
R
, Mazzoccoli
B
, Zanni
G
, Gallina
A
, et al. Holmium laser enucleation versus open prostatectomy for benign prostatic hyperplasia: an inpatient cost analysis
. Urology
. 2006 Aug
;68
(2
):302
–6
. .6.
Kuntz
RM
, Lehrich
K
. Transurethral holmium laser enucleation versus transvesical open enucleation for prostate adenoma greater than 100 gm: a randomized prospective trial of 120 patients
. J Urol
. 2002 Oct
;168
(4 Pt 1
):1465
–9
.7.
García-Segui
A
, Gascón-Mir
M
. Comparative study between laparoscopic extraperitoneal and open adenomectomy
. Actas Urol Esp
. 2012 Feb
;36
(2
):110
–6
. .8.
McCullough
TC
, Heldwein
FL
, Soon
SJ
, Galiano
M
, Barret
E
, Cathelineau
X
, et al. Laparoscopic versus open simple prostatectomy: an evaluation of morbidity
. J Endourol
. 2009 Jan
;23
(1
):129
–33
. .9.
Baumert
H
, Ballaro
A
, Dugardin
F
, Kaisary
AV
. Laparoscopic versus open simple prostatectomy: a comparative study
. J Urol
. 2006 May
;175
(5
):1691
–4
. .10.
Li
J
, Cao
D
, Peng
L
, Ren
Z
, Gou
H
, Li
Y
, et al. Comparison between minimally invasive simple prostatectomy and open simple prostatectomy for large prostates: a systematic review and meta-analysis of comparative trials
. J Endourol
. 2019 Sep
;33
(9
):767
–76
. .11.
Cheng
H
, Clymer
JW
, Po-Han Chen
B
, Sadeghirad
B
, Ferko
NC
, Cameron
CG
, et al. Prolonged operative duration is associated with complications: a systematic review and meta-analysis
. J Surg Res
. 2018 Sep
;229
:134
–44
. .12.
Tubaro
A
, de Nunzio
C
. The current role of open surgery in BPH
. EAU-EBU Update Ser
. 2006
;4
(5
):191
–201
. .13.
Gazel
E
, Kaya
E
, Yalcin
S
, Aybal
HÇ
, Aydogan
TB
, Tunc
L
. Comparison of the efficacy of holmium laser enucleation of the prostate in treating prostate volumes of ≤80 and >80 mL
. Urol Int
. 2019 Feb
;102
(3
):306
–10
. .14.
Ahyai
SA
, Chun
FK
, Lehrich
K
, Dahlem
R
, Zacharias
MS
, Fisch
MM
, et al. Transurethral holmium laser enucleation versus transurethral resection of the prostate and simple open prostatectomy: Which procedure is faster?
J Urol
. 2012 May
;187
(5
):1608
–13
. .15.
Jones
P
, Alzweri
L
, Rai
BP
, Somani
BK
, Bates
C
, Aboumarzouk
OM
. Holmium laser enucleation versus simple prostatectomy for treating large prostates: results of a systematic review and meta-analysis
. Arab J Urol
. 2016 Mar
;14
(1
):50
–8
. .16.
Lin
Y
, Wu
X
, Xu
A
, Ren
R
, Zhou
X
, Wen
Y
, et al. Transurethral enucleation of the prostate versus transvesical open prostatectomy for large benign prostatic hyperplasia: a systematic review and meta-analysis of randomized controlled trials
. World J Urol
. 2016 Sep
;34
(9
):1207
–19
. .17.
Shigemura
K
, Yamamichi
F
, Kitagawa
K
, Yamashita
M
, Oka
Y
, Tanaka
H
, et al. Does surgeon experience affect operative time, adverse events and continence outcomes in holmium laser enucleation of the prostate? a review of more than 1,000 cases
. J Urol
. 2017 Sep
;198
(3
):663
–70
. .18.
Porpiglia
F
, Terrone
C
, Renard
J
, Grande
S
, Musso
F
, Cossu
M
, et al. Transcapsular adenomectomy(Millin): a comparative study, extraperitoneal laparoscopy versus open surgery
. Eur Urol
. 2006 Jan
;49
(1
):120
–6
. .19.
Asimakopoulos
AD
, Mugnier
C
, Hoepffner
JL
, Spera
E
, Vespasiani
G
, Gaston
R
, et al. The surgical treatment of a large prostatic adenoma: the laparoscopic approach: a systematic review
. J Endourol
. 2012 Aug
;26
(8
):960
–7
. .20.
Baldini
A
, Fassi-Fehri
H
, Duarte
RC
, Crouzet
S
, Ecochard
R
, Abid
N
, et al. Holmium laser enucleation of the prostate versus laparoscopic transcapsular prostatectomy: perioperative result s and three-month follow-up
. Curr Urol
. 2017 Jul
;10
(2
):81
–6
. .21.
Fujihara
N
, Lark
ME
, Fujihara
Y
, Chung
KC
. The effect of economic downturn on the volume of surgical procedures: a systematic review
. Int J Surg
. 2017 Aug
;44
:56
–63
. .© 2020 S. Karger AG, Basel
2020
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