MP42-10 CAN THE USE OF PRE-OPERATIVE TRANSRECTAL ULTRASOUND PROSTATE VOLUME PREDICT THEATRE OPERATING TIMES FOR HOLMIUM LASER ENUCLEATION OF THE PROSTATE SURGERY?

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology III1 Apr 2016MP42-10 CAN THE USE OF PRE-OPERATIVE TRANSRECTAL ULTRASOUND PROSTATE VOLUME PREDICT THEATRE OPERATING TIMES FOR HOLMIUM LASER ENUCLEATION OF THE PROSTATE SURGERY? Farooq Khan, M Asad Saleemi, Sanjeev Taneja, Asher Alam, Mohammed Al-Sheikh, Ian Nunney, and Tevita Aho Farooq KhanFarooq Khan More articles by this author , M Asad SaleemiM Asad Saleemi More articles by this author , Sanjeev TanejaSanjeev Taneja More articles by this author , Asher AlamAsher Alam More articles by this author , Mohammed Al-SheikhMohammed Al-Sheikh More articles by this author , Ian NunneyIan Nunney More articles by this author , and Tevita AhoTevita Aho More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.198AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Pre-operative transrectal ultrasound (TRUS) volumes ensure sensible sized prostates are tackled during the learning curve of holmium laser enucleation of the prostate (HoLEP) surgery. We believe the use of TRUS volumes can allow the prediction of operative time not only early in a surgeons experience but also for experienced surgeons to plan theatre lists. METHODS 253 HoLEPs were undertaken with a 50 Watt (W) holmium laser (Auriga XL, Boston Scientific Inc., Richard Wolf Piranha Morcellator) by two HoLEP naive surgeons during their learning curve and subsequently. All patients underwent a TRUS volume pre-operatively (B-K Hawk 2102). Accurate enucleation time and total operating room (OR) time for a given TRUS volume were plotted against TRUS volume to use as a predictive tool to enhance operating list scheduling. RESULTS Statistical analysis; SAS statistical software v9.3. To determine any linear relationship with TRUS volume linear regression and correlation analysis was performed, reporting both the coefficient of regression and Pearsons correlation coefficient. Complete data was available for 249 cases, 4 patients did not have a TRUS volume. Mean prostate volume 62.8cc, mean patient age of 70.1 and a mean PSA of 3.91ng/ml were noted. Mean enucleated weight of 43.3g (95% CI 39.34,47.29) was achieved. Mean enucleation rate across all prostate sizes was 0.60g/min and with BNI cases excluded this reached 0.68 g/min (95% CI 0.61,0.75) with a mean morcellation rate of 3.58 g/min (95% CI 3.30,3.87). A more efficient rate of enucleation with larger prostates was noted. There was a high correlation between TRUS volume and grams/min enucleated (r=0.6019, 95% CI 0.4772,0.7028) and a significant coefficient of regression (p<0.0001) suggesting a fairly strong linear relationship that was matched by total OR times versus TRUS volume (Pearsons correlation 0.6235, 95% CI 0.5418,0.6935, coefficient of regression p<0.0001). Enucleation, morcellation and OR times all had a strong linear relationship with TRUS volume on plots. CONCLUSIONS The use of pre-operative TRUS volume assessment is encouraged in those setting up a HoLEP service. In established units it provides a guide to operative time required for a given prostate size optimizing theatre utilization. We recommend the regular use of this simple tool for this purpose. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e572-e573 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Farooq Khan More articles by this author M Asad Saleemi More articles by this author Sanjeev Taneja More articles by this author Asher Alam More articles by this author Mohammed Al-Sheikh More articles by this author Ian Nunney More articles by this author Tevita Aho More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...