1910 CHANGE OF PRACTICE PATTERNS AFTER THE INTRODUCTION OF THE HOLMIUM LASER ENUCLEATION OF THE PROSTATE IN BENIGN PROSTATIC HYPERPLASIA SURGICAL THERAPY AT A TERTIARY CARE CENTER

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy and New Technology I1 Apr 20101910 CHANGE OF PRACTICE PATTERNS AFTER THE INTRODUCTION OF THE HOLMIUM LASER ENUCLEATION OF THE PROSTATE IN BENIGN PROSTATIC HYPERPLASIA SURGICAL THERAPY AT A TERTIARY CARE CENTER Sascha Ahyai, Felix Chun, Roman Heuer, Hendrik Isbarn, Christian Eichelberg, Eike Eichelberg, Silke Riechard, Roland Dahlem, and Margit Fisch Sascha AhyaiSascha Ahyai More articles by this author , Felix ChunFelix Chun More articles by this author , Roman HeuerRoman Heuer More articles by this author , Hendrik IsbarnHendrik Isbarn More articles by this author , Christian EichelbergChristian Eichelberg More articles by this author , Eike EichelbergEike Eichelberg More articles by this author , Silke RiechardSilke Riechard More articles by this author , Roland DahlemRoland Dahlem More articles by this author , and Margit FischMargit Fisch More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1877AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Holmium laser enucleation of the prostate (HoLEP) was introduced as a minimal invasive surgical therapy in October 2006 at the University Medical Center Hamburg-Eppendorf, Germany. We describe the trend in transurethral resection of the prostate (TURP), open prostatectomy (OP) and HoLEP as surgical treatments for benign prostatic hyperplasia (BPH) from 1999 through 2009 at our tertiary care center. METHODS Retrospectively, all benign prostatic hyperplasia surgeries between 1999 and 2009 were identified using our own data base. All surgeries were categorized according to their surgical technique. First Endpoint was the annual total number of each surgical technique. Secondly we looked at prostate size, operating time and postoperative hospital stay. RESULTS Before HoLEP was introduced in Oct. 2006 the mean annual number of benign prostatic procedures was 123 (TURP n= 80; OP n=43). From 2006 to 2009 the mean annual number of benign prostatic surgeries was 207 (TURP n=55; OP n=19; HoLEP n=130) and increased 168%. In 2009 more than 78% of all benign prostatic treatments were performed minimally invasively by HoLEP and only 2% by OP. After HoLEP was introduced the median estimated prostate volume became significantly lower (53 vs. 43 ccm; p < 0.05) in the TURP-group and significantly higher (110 vs. 118; p<0.05) in the OP-Group. In HoLEP patients the median estimated prostatic volume was 80 ccm (range 20-200). The median operating time was 60, 100 and 76 minutes for TURP, OP and HoLEP respectively. There was a significant different median postoperative hospital stay of 7, 4 and 2 days for OP, TURP and HoLEP (p<0.05). CONCLUSIONS HoLEP contributed to a dramatic increase of the total benign prostatic hyperplasia procedure rate. The increase of HoLEP is accompanied by a continuing decrease of transurethral prostate resection and especially of OP. This dramatic change reflects that HoLEP became the gold standard surgical treatment of benign prostatic hyperplasia at our institution; also because it is prostate size independent, with considerable operating time and a short postoperative hospital stay. Hamburg, Germany© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e742-e743 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sascha Ahyai More articles by this author Felix Chun More articles by this author Roman Heuer More articles by this author Hendrik Isbarn More articles by this author Christian Eichelberg More articles by this author Eike Eichelberg More articles by this author Silke Riechard More articles by this author Roland Dahlem More articles by this author Margit Fisch More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...