Holmium laser enucleation of the prostate: efficiency gained by experience and operative technique

The Journal of Urology
Michael W DusingJ E Lingeman

Abstract

Holmium laser enucleation of the prostate is highly effective for symptomatic benign prostatic hyperplasia. Despite its steep learning curve the procedure is an efficient treatment, especially for large prostate glands. We determined the change in enucleation efficiency with time with increased operative experience and improved technique. We reviewed the records of all 949 consecutive men who underwent holmium laser enucleation of the prostate between 1999 and 2007. Patients were excluded from analysis when enucleated gm or time was not recorded and enucleated tissue was less than 5 gm. Efficiency was measured in gm enucleated prostate tissue per minute. Descriptive statistics on laser time, gland weight and efficiency were evaluated in an 8-year period. A total of 91 patients met study exclusion criteria, leaving 858 available for evaluation. Mean enucleation time was 94 minutes (range 12 to 485). Mean prostate specimen weight was 77 gm (range 5 to 376). Mean efficiency or enucleation rate was 0.55 vs 1.32 gm per minute in the first 4 vs the last 5 years. Further efficiency improvements were noted in the last 5 years with a mean of 1.57 gm per minute enucleated in the last 2 years. As experience with holmium laser enucleation ...Continue Reading

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Citations

Apr 20, 2011·Prostate Cancer and Prostatic Diseases·J Y KangH-L Lee
Dec 1, 2010·Indian Journal of Urology : IJU : Journal of the Urological Society of India·Amy E Krambeck
Aug 7, 2013·Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen·Andrej RaschMatthias Perleth
Aug 27, 2015·The Journal of Urology·Marawan M El TayebJames E Lingeman
Jul 27, 2011·The Journal of Urology·Piotr L ChlostaAndrzej Borówka
Dec 15, 2015·World Journal of Urology·Cesare Marco Scoffone, Cecilia Maria Cracco
Jun 5, 2016·The Surgical Clinics of North America·Jessica Mandeville, Arthur Mourtzinos
Apr 9, 2020·Andrologia·Felipe Carvalho Antunes de FigueiredoCesare Marco Scoffone
May 14, 2020·Journal of Clinical Medicine·Thomas R W HerrmannIoannis Giannakis

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