You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology III1 Apr 2015MP13-04 IS POWER EVERYTHING IN HOLMIUM LASER ENUCLEATION OF THE PROSTATE SURGERY? THE FIRST REPORTED 50 WATT HOLMIUM LASER ENUCLEATION OF THE PROSTATE SERIES. Farooq Khan, Mohamed Asad Saleemi, Sanjeev Taneja, Asher Alam, Ian Nunney, Michal Sut, and Tevita Futo ‘Aho Farooq KhanFarooq Khan More articles by this author , Mohamed Asad SaleemiMohamed Asad Saleemi More articles by this author , Sanjeev TanejaSanjeev Taneja More articles by this author , Asher AlamAsher Alam More articles by this author , Ian NunneyIan Nunney More articles by this author , Michal SutMichal Sut More articles by this author , and Tevita Futo ‘AhoTevita Futo ‘Aho More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.344AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We report a series of 50 Watt (W) holmium laser enucleation of the prostate (HoLEP) undertaken in a single institution. The aim of the study was to report outcomes across all prostate sizes during the learning curve of two surgeons to see if 50W HoLEP surgery is a viable option, both clinically and financially, for hospitals wishing to develop such a service. METHODS Two HoLEP naïve surgeons (FAK, MAS) completed 105 HoLEPs over a 14 month period using a 50W Holmium laser (Auriga XL, StarMedTec GmbH, a Boston Scientific Company). Pre and post operative data including flow rates (Qmax), residual volume (RV), international prostate symptom scores (IPSS), quality of life scores (QoL), total surgical times, hospital stay, histology, haemoglobin (Hb), creatinine (Cr) and catheter times were accurately recorded. RESULTS Wilcoxon non-parametric rank testing using SAS statistical software version 9.3 was used. Median patient age was 70 years, median prostate volume 50cc with a mean enucleation weight of 31.67g (range 1–105g) across the series that included 23 laser bladder neck incisions. Removing these gave a median enucleated weight of 40g. Mean hospital stay was 1.03 days with 11 cases completed as day-case surgery. Mean operating time (enucleation and morcellation) was 104.4 mins. 47 of the 105 cases were for urinary retention (45%), the remainder for symptoms and/or proven urodynamic bladder outlet obstruction. All patients were rendered catheter free with the immediate day 1 post-operative catheter-free rate of 84%. There was marked improvement in flow rates (Qmax) with median increase of 7.9mls/s (p=000.1), IPSS median reduction of 12 points (p=0.0001) and QoL scores by 2 (p=0.0001). A small median decrease in Hb of 1.55g/dl (p=0.0001) was noted, but no transfusions took place in this series and a small clinically insignificant rise in Cr of 5 mmol/l (p=0.0002) was noted. Pre and post-operative RV remained statistically insignificant. 3 cancers were reported in our cohort. Return of the capital investment for the project was achieved by the 16th month, mainly by bed days saved (176.5) compared to our historical cohort of TURP patients, well ahead of the projected plan of 3.25 years CONCLUSIONS Excellent patient outcomes from 50W HoLEP surgery are achievable. This can enable the delivery of a high quality HoLEP service at much reduced financial cost to hospitals wishing to offer this service compared to the current cost of 100W and 120W Holmium laser systems on the market. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e137 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Farooq Khan More articles by this author Mohamed Asad Saleemi More articles by this author Sanjeev Taneja More articles by this author Asher Alam More articles by this author Ian Nunney More articles by this author Michal Sut More articles by this author Tevita Futo ‘Aho More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...