Preoperative predictors of enucleation time during en bloc \u2018no-touch\u2019 holmium laser enucleation of the prostate

Chun-Hsuan Lin,Wen-Jeng Wu,Sheng-Chen Wen,Ching-Chia Li

doi:10.1186/s12894-020-00758-4

Abstract

BackgroundTo evaluate preoperative predictors of enucleation time during en bloc ‘no-touch’ holmium laser enucleation of the prostate (HoLEP)MethodsWe enrolled 135 patients with symptomatic benign prostatic hyperplasia (BPH) treated with en bloc ‘no-touch’ HoLEP from July 2017 to March 2019 by a single surgeon. Preoperative, perioperative, and postoperative clinical variables were examined. Stepwise linear regression was performed to determine clinical variables associated with enucleation times.ResultThe average (range) enucleation time was 46.1 (12–220) minutes, and the overall operation time was 71 (18–250) minutes. History of antiplatelet agents, history of urinary tract infection (UTI), and increasing specimen weight were each significantly associated with increasing enucleation time. No category IV complications were recorded, and all complications were evenly distributed among the groups according to the HoLEP specimen weight.ConclusionEn bloc ‘no-touch’ HoLEP was found to be an efficient and reproducible surgical method for treating BPH. Prostatic gland size was significantly associated with increased enucleation times. Similarly, history of UTI and antiplatelet agents were correlated with increased operative time.

Highlights

To evaluate preoperative predictors of enucleation time during en bloc ‘no-touch’ holmium laser enu‐ cleation of the prostate (HoLEP)
Prostatic gland size was significantly associated with increased enucleation times
History of urinary tract infection (UTI) and antiplatelet agents were correlated with increased operative time

Summary

Introduction

To evaluate preoperative predictors of enucleation time during en bloc ‘no-touch’ holmium laser enu‐ cleation of the prostate (HoLEP). Since the first clinical report on holmium laser enucleation of the prostate (HoLEP) by Gilling et al [1], multiple randomized controlled trials have been conducted. In many of those trials, compared with open prostatectomy and transurethral resection of the prostate (TURP), HoLEP has been proven to have advantages in size independence and minimal invasiveness for treatment of obstructive symptoms from benign prostatic hyperplasia (BPH), with excellent long-term results [2,3,4,5,6]. More recent studies of en bloc procedures could prove the

Methods

Discussion

Conclusion