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TRANSURETHRAL HOLMIUM LASER ENUCLEATION OF THE PROSTATE VERSUS TRANSURETHRAL ELECTROCAUTERY RESECTION OF THE PROSTATE: A RANDOMIZED PROSPECTIVE TRIAL IN 200 PATIENTS

2004; Lippincott Williams & Wilkins; Volume: 172; Issue: 3 Linguagem: Inglês

10.1097/01.ju.0000136218.11998.9e

1527-3792

Rainer M. Kuntz, Sascha Ahyai, Karin Lehrich, Amr Fayad,

Prostate Cancer Diagnosis and Treatment

No AccessJournal of UrologyAdult Urology: Voiding Dysfunction1 Sep 2004TRANSURETHRAL HOLMIUM LASER ENUCLEATION OF THE PROSTATE VERSUS TRANSURETHRAL ELECTROCAUTERY RESECTION OF THE PROSTATE: A RANDOMIZED PROSPECTIVE TRIAL IN 200 PATIENTS RAINER M. KUNTZ, SASCHA AHYAI, KARIN LEHRICH, and AMR FAYAD RAINER M. KUNTZRAINER M. KUNTZ More articles by this author , SASCHA AHYAISASCHA AHYAI More articles by this author , KARIN LEHRICHKARIN LEHRICH More articles by this author , and AMR FAYADAMR FAYAD More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000136218.11998.9eAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Transurethral electrocautery resection (TURP) is generally regarded as the gold standard surgical treatment for bladder outflow obstruction due to benign prostatic hyperplasia despite its rather high morbidity. The high powered holmium:YAG laser can be used endoscopically to enucleate obstructing prostatic tissue in a relatively bloodless manner. The technique of transurethral holmium laser enucleation of the prostate (HoLEP) was compared to standard TURP for the surgical management of prostate adenomas in a randomized, prospective clinical trial. Materials and Methods: A total of 200 urodynamically obstructed patients with a prostate of less than 100 gm on transrectal ultrasound were randomized to HoLEP or TURP. All patients were assessed preoperatively, and 1, 6 and 12 months postoperatively. Patient baseline characteristics, perioperative data and postoperative outcome were compared. All complications were noted. Results: HoLEP was significantly superior to TURP in terms of catheter time, hospital stay and hemoglobin loss but operative time was longer. HoLEP and TURP resulted in a significant improvement in American Urological Association symptom scores, peak urinary flow rates and post-void residual urine volumes with symptoms scores and residual volume significantly better in the holmium group. Effects on continence and potency were similar in the 2 groups but adverse events were less frequent in the holmium group. Conclusions: HoLEP and TURP are highly effective procedures for removing obstructing prostatic adenomas. HoLEP resulted in significantly better micturition parameters and less perioperative morbidity. References 1 : AUA guideline on management of benign prostatic hyperplasia (2003). Chapter 1: diagnosis and treatment recommendations. J Urol2003; 170: 530. Link, Google Scholar 2 : Laser prostatectomy with the holmium: YAG laser. Tech Urol1995; 1: 217. Medline, Google Scholar 3 : Holmium laser resection of the prostate: preliminary results of a new method for the treatment of benign prostatic hyperplasia. 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Volume 172Issue 3September 2004Page: 1012-1016 Advertisement Copyright & Permissions© 2004 by American Urological Association, Inc.Keywordslaser surgeryprostatebladder neck obstructiontransurethral resection of prostateprostatic hyperplasiaMetricsAuthor Information RAINER M. KUNTZ More articles by this author SASCHA AHYAI More articles by this author KARIN LEHRICH More articles by this author AMR FAYAD More articles by this author Expand All Advertisement PDF downloadLoading ...