En bloc holmium laser enucleation of the prostate (HOLEP EN BLOC): our experience


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Аннотация

Introduction. Some authors consider HoLEP a new gold standard for the surgical management of prostatic hyperplasia. The increasing utilization of holmium enucleation has led to the development of various modifications of this treatment modality, including the so-called enucleation as a single piece (HoLEP en bloc), which reduces the operative time and, according to some authors, facilitates acquiring new surgical technique by surgical trainees. Aim. To compare the effectiveness and safety of the traditional HoLEP and HoLEP en bloc. Materials and methods. The study comprised 227 BPH patients aged from 53 to 86 years old (mean - 61.38+5.09 years). HoLEP en bloc was performed in 114 patients, of whom 39 patients had prostate volume (Vpr) less than 80 cm3, and in 75 patients it was more than 80 cm3. The standard HoLEP was performed in 113 patients, of whom 41 patients had Vpr less than 80 cm3, and in 72 patients it was more than 80 cm3. Results. Enucleation time: HoLEP - 48+12 min, HoLEP en-bloc - 35±10; morcellation time: HoLEP - 20±3 min, HolEp en-bloc - 16±12; duration of urinary bladder drainage by a urethral catheter: HoLEP - 58±3 h, HoLEP en-bloc - 41±2; length ofhospital stay: HoLEP - 5.93±0.39 days, HoLEP en-bloc - 4.45±0.35; bladder tamponade, urethrocystoscopy and coagulation of bleeding vessels: HoLEP-3, HoLEP en-bloc-1; infectious-inflammatory complications (prostatitis): HoLEP-3, HoLEP en-bloc-2; acute urinary retention, stress urinary incontinence: HoLEP-6, HoLEP en-bloc-2; stress urinary incontinence: HoLEP - 5, HoLEP en-bloc - 2. Conclusion. En bloc holmium enucleation of the prostate results in the reduction of enucleation and total operative time compared with traditional HoLEP due to the fast identification of the surgical capsule and the right layer. Using this technique can improve the effectiveness of learning holmium laser enucleation of the prostate by surgical trainees.

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Авторлар туралы

L. Rapoport

I.M. Sechenov First MSMU (Sechenov University) of Minzdrav of Russia

Email: leonidrapoport@yandex.ru
Dr.Med.Sci., Prof. at the Department of Urology, Deputy Director for Medical work of the Research Institute for Uronephrology and Human Reproductive Health

N. Sorokin

I.M. Sechenov First MSMU (Sechenov University) of Minzdrav of Russia

Email: msorokin@mail.ru
Dr.Med.Sci., Head of the Department Urology № 3, R.M. Fronstein Clinic of Urology

R. Sukhanov

I.M. Sechenov First MSMU (Sechenov University) of Minzdrav of Russia

Email: rb_suhanov@mail.ru
Ph.D., Teaching Assistant at the Department of Urology

A. Dymov

I.M. Sechenov First MSMU (Sechenov University) of Minzdrav of Russia

Email: alimdv@mail.ru
Ph.D., Teaching Assistant at the Department of Urology

D. Enikeev

I.M. Sechenov First MSMU (Sechenov University) of Minzdrav of Russia

Email: enikeev_dv@mail.ru
Ph.D., Deputy Director for Clinical Care of the Research Institute for Uronephrology and Human Reproductive Health

D. Davydov

I.M. Sechenov First MSMU (Sechenov University) of Minzdrav of Russia

Email: ares9999@mail.ru
Urologist at the Department Urology № 3, R.M. Fronstein Clinic of Urology

S. Danilov

I.M. Sechenov First MSMU (Sechenov University) of Minzdrav of Russia

Email: spdanilov@gmail.com
Ph.D. Student at the Department of Urology

Әдебиет тізімі

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