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The effect of prostatic tissue density on the perioperative outcomes of Holmium laser enucleation of prostate (HoLEP): a pilot study

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Abstract

Purpose

To evaluate the effect of prostate tissue density (PTD) on perioperative Holmium laser enucleation of prostate (HoLEP) outcomes.

Methods

Two hundred fourteen patients underwent HoLEP between December 2016 and August 2018 (group 1: PTD < 1 g/mL and group 2: PTD ≥ 1 g/mL). Enucleation time (ET), morcellation time (MT), total operation time (TOT), total laser energy (TLE), efficiency of laser (EL), efficiency of enucleation (EE), efficiency of morcellation (EM), enucleation rate (ER), and enucleated tissue weight (ETW) were recorded.

Results

The mean ages of the groups 1, 2 were 61.36±5.92 and 63.1±7.52 years, respectively. TOT (76.4 vs 86.21 min), ET (69.18 vs 79.94 min), EE (0.80 vs 0.91 g/min), and ETW (55.8 vs 70.23 g) were not significantly different between the two groups. However, the MT was longer in group 2 (11.27 ± 8.57 min and 7.22 ± 5.46 min, p = 0.0001). Furthermore, EM was higher in group 1 (9.81 ± 5.61 g/min and 7.45 ± 4.14 g/min, p = 0.0003). The EL and TLE were similar in both groups. PTD positively correlated with MT (ρ = 0.272, p = 0.0005) and negatively correlated with EM (ρ = − 0.315, p = 0.0001). No correlations were identified between the PTD and EL or EE.

Conclusions

PTD is a factor that influences the HoLEP on perioperative outcomes. The PTD particularly affects the morcellation phase of the surgery. Patients with higher PTD will have a longer duration of MT and lesser EM. Future studies with the use of different imaging methods will give insight into the duration and difficulty of the HoLEP.

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Funding

This study was not funded.

Author information

Authors and Affiliations

  1. Department of Urology, Gulhane Training and Research Hospital, Health Science University, General Tevfik Saglam Caddesi, Etlik, Ankara, Turkey

    Engin Kaya & Serdar Yalcın

  2. Department of Urology, Acıbadem University Ankara Hospital, Ankara, Turkey

    Eymen Gazel

  3. Department of Urology and Andrology, General Hospital Hall i.T, Hall in Tirol, Austria

    Theodoros Tokas

  4. Department of Urology, Kahramanmaraş Goksun State Hospital, Kahramanmaraş, Turkey

    Tahsin Batuhan Aydogan

  5. Department of Urology, Ankara Oncology Training and Research Hospital, Ankara, Turkey

    Halil Cagrı Aybal

  6. Department of Urology, Gazi University School of Medicine, Ankara, Turkey

    Lutfi Tunc

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  1. Engin Kaya
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Contributions

EK: Protocol/project development, data analysis, and manuscript writing. EG: Project development and manuscript writing. SY: Data collection. TT: Manuscript writing and editing. TBA: Data collection. HCA: Data collection. LT: Project development, data analysis, and manuscript writing and editing.

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Correspondence to Engin Kaya.

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Kaya, E., Gazel, E., Yalcın, S. et al. The effect of prostatic tissue density on the perioperative outcomes of Holmium laser enucleation of prostate (HoLEP): a pilot study. World J Urol 38, 455–461 (2020). https://doi.org/10.1007/s00345-019-02802-x

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  • DOI: https://doi.org/10.1007/s00345-019-02802-x

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