Holmium Laser Enucleation of Prostate for Benign Prostatic Hyperplasia: Seoul National University Hospital Experience
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Purpose: The objective of this study was to report the experience acquired at the Seoul National University Hospital with Holmium Laser Enucleation of Prostate (HoLEP), combined with mechanical morcellation for symptomatic benign prostatic hyperplasia (BPH). Methods: A retrospective review was performed on the clinical data of 309 consecutive patients who underwent HoLEP at our institution between July 2008 and June 2010. All patients were evaluated preoperatively for prostate volume by transrectal ultrasound,maximum urinary flow rate (Qmax), International Prostate Symptoms Score (IPSS) and quality of life (QoL) score. Peri- and postoperative parameters were evaluated and patients were followed-up at 1-, 3-, 6-, and 12- months with the aforementioned investigations. Results: The patients’ mean age was 68.3 (±6.5) years and mean prostate volume was 55.6 (±23.6) mL. Mean enucleation time was 56.2 (±25.1) minutes, mean morcellation time was 11.3 (±9.5) minutes, and the mean resected weight of the prostate was 20.8 (±16.9) g. The mean catheter indwelling period was 1.9 (±1.7) days and mean hospital stay was 2.9 (±1.5) days. Significant improvement was noted in Qmax, IPSS, and QoL at the 1-year follow-up compared with baseline (P<0.01). At 1 month 17.2% of patients complained of irritative urinary symptoms, which were typically self-limiting within 3 months. Transient stress incontinence was reported in 15.2% of patients. No patient experienced persistent obstructive symptoms that required reoperation. Conclusions: Our study showed that HoLEP is a safe and effective therapeutic modality for BPH.
Abstract
Purpose: The objective of this study was to report the experience acquired at the Seoul National University Hospital with Holmium Laser Enucleation of Prostate (HoLEP), combined with mechanical morcellation for symptomatic benign prostatic hyperplasia (BPH). Methods: A retrospective review was performed on the clinical data of 309 consecutive patients who underwent HoLEP at our institution between July 2008 and June 2010. All patients were evaluated preoperatively for prostate volume by transrectal ultrasound,maximum urinary flow rate (Qmax), International Prostate Symptoms Score (IPSS) and quality of life (QoL) score. Peri- and postoperative parameters were evaluated and patients were followed-up at 1-, 3-, 6-, and 12- months with the aforementioned investigations. Results: The patients’ mean age was 68.3 (±6.5) years and mean prostate volume was 55.6 (±23.6) mL. Mean enucleation time was 56.2 (±25.1) minutes, mean morcellation time was 11.3 (±9.5) minutes, and the mean resected weight of the prostate was 20.8 (±16.9) g. The mean catheter indwelling period was 1.9 (±1.7) days and mean hospital stay was 2.9 (±1.5) days. Significant improvement was noted in Qmax, IPSS, and QoL at the 1-year follow-up compared with baseline (P<0.01). At 1 month 17.2% of patients complained of irritative urinary symptoms, which were typically self-limiting within 3 months. Transient stress incontinence was reported in 15.2% of patients. No patient experienced persistent obstructive symptoms that required reoperation. Conclusions: Our study showed that HoLEP is a safe and effective therapeutic modality for BPH.
참고문헌 (20)
- Arrighi HM, "Natural history of benign prostatic hyperplasia and risk of prostatectomy. The Balti\-more Longitudinal Study of Aging", Urology, 38(1 Suppl), pp.4~8 (1991)
- AUA Practice Guidelines Committee, "AUA guideline on management of benign prostatic hyperplasia (2003). Chapter 1: Diagnosis and treatment recommendations", J Urol, 170(2 Pt 1), pp.530~547 (2003)
- Kuntz RM, "Current role of lasers in the treatment of benign pros\-tatic hyperplasia (BPH)", Eur Urol, 49, pp.961~969 (2006)
- Gilling PJ, "Combination holmium and Nd: YAG laser ablation of the prostate: initial clinical experience", J Endourol, 9, pp.151~153 (1995)
- Ahyai SA, "Holmium laser enucleation versus transurethral resection of the prostate: 3-year follow-up results of a randomized clinical trial", Eur Urol, 52, pp.1456~1463 (2007)
- Kuntz RM, "Transurethral holmium laser enucleation versus transvesical open enucleation for prostate adenoma greater than 100 gm: a randomized prospective trial of 120 patients", J Urol, 168(4 Pt 1), pp.1465~1469 (2002)
- Gilling PJ, "Holmium laser enucleation of the prostate (HoLEP) combined with transurethral tissue morcellation: an update on the early clini\-cal experience", J Endourol, 12, pp.457~459 (1998)
- Shah HN, "Prospective evaluation of the learning curve for holmium laser enucleation of the prostate", J Urol, 177, pp.1468~1474 (2007)
- Seki N, "Holmium laser enucleation for prostatic adenoma: analysis of learning curve over the course of 70 consecutive cases", J Urol, 170, pp.1847~1850 (2003)
- 배정범, "The Learning Curve for Holmium Laser Enucleation of the Prostate: A Single-Center Experience", Korean Journal of Urology, 51(10), pp.688~693 (2010), 대한비뇨기과학회
- Vavassori I, "Three-year outcome following holmium laser enucleation of the prostate combined with mechanical morcellation in 330 consecutive patients", Eur Urol, 53, pp.599~604 (2008)
- Elzayat EA, "Holmium laser enucleation of the prostate: a size-independent new “gold standard”", Urology, 66(5 Suppl), pp.108~113 (2005)
- Shah HN, "Peri-operative complications of holmium laser enucleation of the prostate: experience in the first 280 patients, and a review of literature", BJU Int, 100, pp.94~101 (2007)
- Naspro R, "Holmium laser enucleation of the prostate versus open prostatectomy for prostates >70 g: 24-month follow-up", Eur Urol, 50, pp.563~568 (2006)
- Larner TR, "Day-case holmium laser enu-cleation of the prostate for gland volumes of < 60 mL: early experi-ence", BJU Int, 91, pp.61~64 (2003)
- Fong BC, "Holmium: YAG Laser enucleation of the prostate: multimedia description from a trainee’s perspective", J Endourol, 18, pp.791~794 (2004)
- Montorsi F, "Holmium laser enucleation versus transurethral resection of the prostate: results from a 2-center, prospective, randomized trial in patients with obstructive benign prostatic hyperplasia", J Urol, 172(5 Pt 1), pp.1926~1929 (2004)
- Wilson LC, "A randomised trial comparing holmium la\-ser enucleation versus transurethral resection in the treatment of prostates larger than 40 grams: results at 2 years", Eur Urol, 50, pp.569~573 (2006)
- Naspro R, "Holmium laser enucleation versus transurethral resection of the prostate. Are histological findings comparable", J Urol, 171, pp.1203~1206 (2004)
- Gratzke C, "Complications and early postoperative outcome after open prosta\-tectomy in patients with benign prostatic enlargement: results of a prospective multicenter study", J Urol, 177, pp.1419~1422 (2007)
