PD27-08 ENDOSCOPIC ENUCLEATION OF THE PROSTATE IN THE LEARNING CURVE VERSUS OPEN SIMPLE PROSTATECTOMY: MORBIDITY AND EARLY FUNCTIONAL OUTCOMES

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You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology IV1 Apr 2017PD27-08 ENDOSCOPIC ENUCLEATION OF THE PROSTATE IN THE LEARNING CURVE VERSUS OPEN SIMPLE PROSTATECTOMY: MORBIDITY AND EARLY FUNCTIONAL OUTCOMES Benjamin PRADERE, Benoit PEYRONNET, Jérome Gas, Benoit Bordier, Pascal Rischmann, Julien Guillotreau, Mathieu Thoulouzan, Michel Soulié, Kevin Zorn, Xavier Gamé, and Vincent Misraï Benjamin PRADEREBenjamin PRADERE More articles by this author , Benoit PEYRONNETBenoit PEYRONNET More articles by this author , Jérome GasJérome Gas More articles by this author , Benoit BordierBenoit Bordier More articles by this author , Pascal RischmannPascal Rischmann More articles by this author , Julien GuillotreauJulien Guillotreau More articles by this author , Mathieu ThoulouzanMathieu Thoulouzan More articles by this author , Michel SouliéMichel Soulié More articles by this author , Kevin ZornKevin Zorn More articles by this author , Xavier GaméXavier Gamé More articles by this author , and Vincent MisraïVincent Misraï More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1229AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Endoscopic enucleation of the prostate (EEP) is considered as a less invasive treatment than open simple prostatectomy (OP) for prostate adenoma >80 ml. Nevertheless, the learning curve of EEP is still challenging. Our objective was to assess perioperative outcomes and functional results between EEP (GreenLEP and HoLEP) within the learning curve and OP done by experimented surgeons. METHODS We prospectively enrolled the first 30 cases of GreenLEP and the first 32 cases of HoLEP which have been grouped together (EEP group) and retrospectively compared them with the 46 consecutives OP performed by seasoned senior surgeons (OP group). Greenlight® enucleation was performed with the «en bloc» technic (GreenLEP) using the HPS® fibre, HoLEP was performed with three lobes technic using the Lumenis® laser 100W Holmium. We collected patient′s characteristics, perioperative outcomes, functional results and complications after a 6-months follow-up. Comparisons between groups were performed using χ2 test and Fisher exact test for discrete variables and Mann-Whitney test for continuous variables. RESULTS Patients characteristics were similar except for prostate volume (OP: 139 ±6.2g, EEP: 102 ±7,5; P<0.001). Operative time was longer in the EEP group (108 ±4min vs 76 ±5min; P<0.001). Time before catheter removal was shorter in the EEP group (P<0.001) and hospital length of stay which was higher in the OP group (9.5 ±0.4 days vs 4.3 ±0.3 days, P<0.001). Complications rate was lower in the EEP: 24% (n=15) vs 46% (n=21); P=0.02 (Table 1). Decrease of prostate volume, IPSS and quality of life score were similar between both groups. Postoperative stress urinary incontinence was comparable between groups at 1 month (40% vs 26.8%, p=0.15) and 3 months (22.4% vs 12.5%, P= 0.19) of follow-up. CONCLUSIONS Whatever the laser technic (Greenlight or holmium), we suggest that endoscopic enucleation remains less morbid and provides similar functional outcomes than OP even in the learning curve. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e514 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Benjamin PRADERE More articles by this author Benoit PEYRONNET More articles by this author Jérome Gas More articles by this author Benoit Bordier More articles by this author Pascal Rischmann More articles by this author Julien Guillotreau More articles by this author Mathieu Thoulouzan More articles by this author Michel Soulié More articles by this author Kevin Zorn More articles by this author Xavier Gamé More articles by this author Vincent Misraï More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...