Holmium laser enucleation for large prostate hyperplasia: assessment of functional outcomes and postoperative complications
Introduction. To date, there has been insufficient research into the prostate volume as a factor that may influence the effectiveness and safety of surgical treatments. With the advent of relatively new laser techniques, it is important to take a closer look at this parameter, especially considering the...
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Ministry of Health of Russian Federation, Rostov State Medical University, State Budget Educational Institute of Higher Professional Education
2024-04-01
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| author | S. V. Kotov R. A. Perov I. A. Zhestkov A. A. Novikov A. A. Nemenov |
| author_facet | S. V. Kotov R. A. Perov I. A. Zhestkov A. A. Novikov A. A. Nemenov |
| author_sort | S. V. Kotov |
| collection | DOAJ |
| description | Introduction. To date, there has been insufficient research into the prostate volume as a factor that may influence the effectiveness and safety of surgical treatments. With the advent of relatively new laser techniques, it is important to take a closer look at this parameter, especially considering the success of these techniques in the treatment of benign prostatic hyperplasia (BPH) of various volumes.Objective. To assess the functional outcomes and postoperative complications of holmium laser enucleation of the prostate (HoLEP) depending on its volume.Materials & Methods. We performed a prospective study of HoLEP on 252 patients. Patients were divided into two groups according to their prostate volume: Group I included 206 patients (81%) with a prostate volume of < 100 mL, and Group II included 46 patients (19%) with a prostate volume ≥ 100 mL.Results. The prostate volume was the most significant prognostic factor regarding duration of surgery. This indicator significantly differed between the two groups. Group I had an average surgery time of 67.1 ± 26.7 minutes, while Group II had a time of 98.1 ± 24.2 minutes (p < 0.05). There were no significant differences in the number of complications between the groups — 36 cases (17.5%) in Group I and 12 cases (26%) in Group II, as well as functional results of urination between the groups. In the early postoperative period, the Q max in Group I was 17.4 ± 9.1 ml/s, in Group II — 18.2 ± 10.9 ml/s (p > 0.05), PVR — 52 ± 39.4 and 56 ± 31.8 ml (p > 0.05), respectively. After 3 months of observation, there were also no differences in the studied parameters: IPSS — 5.7 ± 4.1 vs 6.2 ± 4.9 points; QoL — 1.0 ± 0.9 vs 1.1 ± 0.9 points; Q max — 18.9 ± 6.7 vs 20.3 ± 11.5 ml/s; PVR — 53.5 ± 33.1 vs 54.9 ± 30.6 ml (p > 0.05).Conclusion. HoLEP is an effective and safe method of treating patients with different volumes of BPH. However, the duration of the procedure is an important factor that influences the surgery outcome, as it correlates with the prostate volume. |
| format | Article |
| id | doaj-art-652d5e7d281b4fd39b81806f4e6de4fe |
| institution | Matheson Library |
| issn | 2308-6424 |
| language | Russian |
| publishDate | 2024-04-01 |
| publisher | Ministry of Health of Russian Federation, Rostov State Medical University, State Budget Educational Institute of Higher Professional Education |
| record_format | Article |
| series | Вестник урологии |
| spelling | doaj-art-652d5e7d281b4fd39b81806f4e6de4fe2025-08-04T12:51:16ZrusMinistry of Health of Russian Federation, Rostov State Medical University, State Budget Educational Institute of Higher Professional EducationВестник урологии2308-64242024-04-01122334210.21886/2308-6424-2024-12-2-33-42516Holmium laser enucleation for large prostate hyperplasia: assessment of functional outcomes and postoperative complicationsS. V. Kotov0R. A. Perov1I. A. Zhestkov2A. A. Novikov3A. A. Nemenov4Pirogov Russian National Research Medical University (Pirogov Medical University); Pirogov City Clinical Hospital No. 1; "Kommunarka" Moscow Multidisciplinary Medical CentrePirogov Russian National Research Medical University (Pirogov Medical University); Yudin City Clinical HospitalPirogov Russian National Research Medical University (Pirogov Medical University)Yudin City Clinical HospitalPirogov Russian National Research Medical University (Pirogov Medical University); Yudin City Clinical HospitalIntroduction. To date, there has been insufficient research into the prostate volume as a factor that may influence the effectiveness and safety of surgical treatments. With the advent of relatively new laser techniques, it is important to take a closer look at this parameter, especially considering the success of these techniques in the treatment of benign prostatic hyperplasia (BPH) of various volumes.Objective. To assess the functional outcomes and postoperative complications of holmium laser enucleation of the prostate (HoLEP) depending on its volume.Materials & Methods. We performed a prospective study of HoLEP on 252 patients. Patients were divided into two groups according to their prostate volume: Group I included 206 patients (81%) with a prostate volume of < 100 mL, and Group II included 46 patients (19%) with a prostate volume ≥ 100 mL.Results. The prostate volume was the most significant prognostic factor regarding duration of surgery. This indicator significantly differed between the two groups. Group I had an average surgery time of 67.1 ± 26.7 minutes, while Group II had a time of 98.1 ± 24.2 minutes (p < 0.05). There were no significant differences in the number of complications between the groups — 36 cases (17.5%) in Group I and 12 cases (26%) in Group II, as well as functional results of urination between the groups. In the early postoperative period, the Q max in Group I was 17.4 ± 9.1 ml/s, in Group II — 18.2 ± 10.9 ml/s (p > 0.05), PVR — 52 ± 39.4 and 56 ± 31.8 ml (p > 0.05), respectively. After 3 months of observation, there were also no differences in the studied parameters: IPSS — 5.7 ± 4.1 vs 6.2 ± 4.9 points; QoL — 1.0 ± 0.9 vs 1.1 ± 0.9 points; Q max — 18.9 ± 6.7 vs 20.3 ± 11.5 ml/s; PVR — 53.5 ± 33.1 vs 54.9 ± 30.6 ml (p > 0.05).Conclusion. HoLEP is an effective and safe method of treating patients with different volumes of BPH. However, the duration of the procedure is an important factor that influences the surgery outcome, as it correlates with the prostate volume.https://www.urovest.ru/jour/article/view/853prostatebenign prostate hyperplasialaser enucleationsurgery |
| spellingShingle | S. V. Kotov R. A. Perov I. A. Zhestkov A. A. Novikov A. A. Nemenov Holmium laser enucleation for large prostate hyperplasia: assessment of functional outcomes and postoperative complications Вестник урологии prostate benign prostate hyperplasia laser enucleation surgery |
| title | Holmium laser enucleation for large prostate hyperplasia: assessment of functional outcomes and postoperative complications |
| title_full | Holmium laser enucleation for large prostate hyperplasia: assessment of functional outcomes and postoperative complications |
| title_fullStr | Holmium laser enucleation for large prostate hyperplasia: assessment of functional outcomes and postoperative complications |
| title_full_unstemmed | Holmium laser enucleation for large prostate hyperplasia: assessment of functional outcomes and postoperative complications |
| title_short | Holmium laser enucleation for large prostate hyperplasia: assessment of functional outcomes and postoperative complications |
| title_sort | holmium laser enucleation for large prostate hyperplasia assessment of functional outcomes and postoperative complications |
| topic | prostate benign prostate hyperplasia laser enucleation surgery |
| url | https://www.urovest.ru/jour/article/view/853 |
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