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Holmium Laser Enucleation for Prostatic Adenoma: Analysis of Learning Curve Over the Course of 70 Consecutive Cases
- Source :
- Journal of Urology. 170:1847-1850
- Publication Year :
- 2003
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2003.
-
Abstract
- We elucidate the learning curve, efficacy and safety of holmium laser enucleation of prostatic adenomas.We retrospectively reviewed data on 70 patients who had undergone holmium laser enucleation for prostatic adenoma. All patients were assessed preoperatively and at an interval of 6 months postoperatively based on the International Prostate Symptom Score, quality of life index, peak urinary flow rate and post-void residual urine measurement. All complications were noted. The relationship between the number of procedures performed and treatment efficacy was analyzed. The learning curve with regard to efficiency for tissue enucleation and morcellation was assessed.Holmium laser enucleation of the prostate resulted in a significant improvement in subjective symptoms and urodynamic parameters. The ratio of improvement in the preoperative-to-postoperative peak urinary flow rate, post-void residual urine, International Prostate Symptom Score and quality of life index did not change significantly as experience increased. However, the efficiency of enucleation increased significantly as experience increased. Complications included short-term stress urinary incontinence in 8 cases and postoperative urethral stricture in 5. Bladder injury during morcellation was observed in 2 cases.Holmium laser enucleation of the prostate is an effective treatment option for benign prostatic adenoma, providing good treatment efficacy and minimal bleeding even if the surgeon has minimal experience. It requires more time to perform than traditional surgery but there is a learning curve for the enucleation technique as experience increases. Technical improvement in tissue morcellation may be necessary if the prevalence of this treatment is to increase dramatically.
- Subjects :
- Male
medicine.medical_specialty
Adenoma
Urology
Urinary Bladder
Enucleation
Prostatic Hyperplasia
Holmium laser
Postoperative Complications
Quality of life
Prostate
Humans
Medicine
Aged
Retrospective Studies
Aged, 80 and over
business.industry
Middle Aged
medicine.disease
Treatment efficacy
Surgery
Urinary Bladder Neck Obstruction
Urodynamics
Treatment Outcome
medicine.anatomical_structure
Patient Satisfaction
Quality of Life
International Prostate Symptom Score
Laser Therapy
business
Urinary flow
Subjects
Details
- ISSN :
- 15273792 and 00225347
- Volume :
- 170
- Database :
- OpenAIRE
- Journal :
- Journal of Urology
- Accession number :
- edsair.doi.dedup.....e121b5f91b53a26c297232ab9a6271ae