Abstract

Purpose: Holmium laser enucleation of the prostate (HoLEP) entails both enucleation and morcellation. Only three popular prostate morcellation devices are available for this procedure. In this study, a retrospective review was done to compare the Wolf® and Storz® morcellators. Materials and Methods: After Institutional Review Board approval, a multi-institutional retrospective chart review of prospectively collected data was performed at two institutions with a single surgeon at each center performing HoLEP. Thunder Bay Regional Health Sciences Center employed the Storz morcellator while Baylor Scott and White Medical Center used the Wolf. Preoperative, perioperative, postoperative, and demographic data for both sets of patients were analyzed and compared retrospectively. Results: A total of 506 patients in the Wolf cohort and 60 patients in the Storz cohort were analyzed. Morcellated pathologic weight was 52.3 g in the Wolf arm and 101.7 g on the Storz arm (p < 0.0001). Overall, average morcellation rates were faster in the Storz arm; morcellation rate was 5.8 g/min for Wolf, and 6.7 g/min in the Storz (p = 0.0015). Morcellator malfunction was significantly lower in Wolf cohort 0% vs 6.6% in the Storz (p = 0.0001), but this did not significantly slow morcellator efficiency times. The total number of mucosal bladder injuries was comparable with rates of 1.4% and 1.6% in the Wolf and Storz groups, respectively (p = 0.59). The duration of hospital stay and catheterization were <24 hours in both groups. Conclusions: In this retrospective study, the Storz DrillCut had higher efficacy in morcellation when compared with Wolf Piranha. However, it was associated with more malfunctions. Both morcellators have comparable rates of complications and perioperative outcomes.

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