<abstract xmlns="http://www.w3.org/1999/xhtml">

<p>In the last decade, the Holmium Laser Enucleation of the Prostate (HoLEP) has become the new gold standard for surgical treatment of benign prostatic hyperplasia (BPH). This treatment has several modifications, and the latest one is en bloc (single piece) enucleation. This new method reduces the operative time and risk of early incontinence. The long-term effect is much better than transurethral resection of the prostate (TURP). We applied an effective method for treating benign prostatic hyperplasia with maximum safety, minimal hospital stays, short operative time, and minimal complications. We operated on 50 patients with BPH with a prostate volume between 30-120 cc. Transrectal ultrasound, uroflowmetry, PSA test, IPSS (International Prostate Symptom Score), residual urine, digital rectal examination, and laboratory blood and urine tests were performed preoperatively. We used Holmium laser (Auriga XL) 50 W, 600 μm fiber and morcellator (Richard Wolf PIRANHA). During the procedure, the laser’s operating power was 36 W. En bloc Holmium enucleation was performed in all patients, followed by morcellation of the prostatic tissue. The time for enucleation was 11-52 min, morcellation time - 1-10 min, the weight of the enucleated tissue - 15-100 g, enucleation efficiency - 0.67-3.03 g/min, postoperative catheterization time - 24-72h, and hospital stay was 1 to 3 days. One blood transfusion was required. There were no patients with postoperative incontinence or other complications. We conclude that еn bloc Holmium enucleation in BPH is an effective method of treatment that offers maximum performance combined with short operative time, shorter hospital stays, and minimal risk of complications. The learning curve requires at least twenty cases. The recommended prostate gland size for the initial trial should be between 50-60 cc. Starting with small-sized glands increases the risk of capsule perforation, and the enucleation plane is more difficult to find.</p>
</abstract>

In the last decade, the Holmium Laser Enucleation of the Prostate (HoLEP) has become the new gold standard for surgical treatment of benign prostatic hyperplasia (BPH). This treatment has several modifications, and the latest one is en bloc (single piece) enucleation. This new method reduces the operative time and risk of early incontinence. The long-term effect is much better than transurethral resection of the prostate (TURP). We applied an effective method for treating benign prostatic hyperplasia with maximum safety, minimal hospital stays, short operative time, and minimal complications. We operated on 50 patients with BPH with a prostate volume between 30-120 cc. Transrectal ultrasound, uroflowmetry, PSA test, IPSS (International Prostate Symptom Score), residual urine, digital rectal examination, and laboratory blood and urine tests were performed preoperatively. We used Holmium laser (Auriga XL) 50 W, 600 μm fiber and morcellator (Richard Wolf PIRANHA). During the procedure, the laser’s operating power was 36 W. En bloc Holmium enucleation was performed in all patients, followed by morcellation of the prostatic tissue. The time for enucleation was 11-52 min, morcellation time - 1-10 min, the weight of the enucleated tissue - 15-100 g, enucleation efficiency - 0.67-3.03 g/min, postoperative catheterization time - 24-72h, and hospital stay was 1 to 3 days. One blood transfusion was required. There were no patients with postoperative incontinence or other complications. We conclude that еn bloc Holmium enucleation in BPH is an effective method of treatment that offers maximum performance combined with short operative time, shorter hospital stays, and minimal risk of complications. The learning curve requires at least twenty cases. The recommended prostate gland size for the initial trial should be between 50-60 cc. Starting with small-sized glands increases the risk of capsule perforation, and the enucleation plane is more difficult to find.

First Fifty Cases with En-Bloc Holmium Laser Enucleation of the Prostate

University Hospital “Dr. Georgi Stranski” – Pleven, Medical University – Pleven

St. Marina University Hospital, Pleven, Medical University – Pleven

Journal of Biomedical and Clinical Research

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

{"article-title":"First Fifty Cases with En-Bloc Holmium Laser Enucleation of the Prostate"}

In the last decade, the Holmium Laser Enucleation of the Prostate (HoLEP) has become the new gold standard for surgical treatment of benign prostatic...

First Fifty Cases with En-Bloc Holmium Laser Enucleation of the Prostate

Published Online: Jul 13, 2022

Page range: 65 - 69

Received: Jan 18, 2022

Accepted: May 11, 2022

DOI: https://doi.org/10.2478/jbcr-2022-0008

Keywords
benign prostatic hyperplasia, holmium laser, en-bloc enucleation, morcellation

© 2022 Georgi S. Georgiev et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

First Fifty Cases with En-Bloc Holmium Laser Enucleation of the Prostate

Published Online: Jul 13, 2022

Page range: 65 - 69

Received: Jan 18, 2022

Accepted: May 11, 2022

DOI: https://doi.org/10.2478/jbcr-2022-0008

Keywordsbenign prostatic hyperplasia, holmium laser, en-bloc enucleation, morcellation

© 2022 Georgi S. Georgiev et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
benign prostatic hyperplasia, holmium laser, en-bloc enucleation, morcellation