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Der Urologe

, 48:1490 | Cite as

Ambulante Holmiumlaserenukleation und mechanische Morcellierung der Prostata

  • R. Abrolat
  • K. Langer
  • N. Roos
Originalien

Zusammenfassung

Hintergrund

Die Holmiumlaserenukleation (HoLEP) der Prostata etabliert sich zunehmend als komplikationsarme alternative Methode zur Referenzmethode TUR-P (transurethrale Prostataresektion) bzw. TVP (transurethral electrovaporisation of the prostate) bei der Behandlung der symptomatischen BPH (benigne Prostatahyperplasie). Seit Einführung der mechanischen Gewebemorcellierung 1998 konnte die Effizienz der Methode gesteigert werden. Wir untersuchen Effizienz und Komplikationen eines Morcellators im ambulanten Umfeld.

Methoden

Von 2004 bis 2008 wurde bei 137 Männer die Prostata mit einem 80-W-Holmium:YAG-Laser behandelt und das Gewebe anschließend morcelliert.

Ergebnisse

Das Durchschnittsalter der Patienten betrug 68,0±7,1 (51–86) Jahre. Die durchschnittliche Morcellierungszeit betrug 8,6±6,8 (1–35) min. Das Gewicht des enukleierten Gewebes betrug 36,6±30,0 (2–175) g. Die Eingriffsdauer lag bei 69,6±28,7 (29–150) min, die Morcellierungsgeschwindigkeit bei 5,0±,6 (0,2–11,5) g/min. Die morcellierungsbedingte Komplikationsrate lag bei 4,3%.

Schlussfolgerung

Die HoLEP mit der mechanischen Morcellierung stellt auch im ambulanten Bereich eine sichere Methode dar. Die Gesamtoperationszeiten nähren sich denen der TUR-P, so dass die verlängerte Operationszeit als Argument gegen die Methode an Gewicht verliert. Komplikationen durch die Morcellierung sind selten und nicht gravierend. Weitere technische Verbesserungen der Morcellatoren sind wünschenswert.

Schlüsselwörter

HoLEP Morcellierung Ambulant BPH Laser 

Day-case holmium laser enucleation and mechanical morcellation of the prostate

Abstract

Background

Holmium laser enucleation of the prostate (HoLEP) is increasingly being used as an alternative to transurethral resection of the prostate (TURP) and transurethral electrovaporisation of the prostate (TVP), the“gold standard” procedures for treating symptomatic benign prostatic hyperplasia. Mechanical tissue morcellation was introduced in 1998, and its efficiency could be improved. We investigated the efficiency and complication rate of a morcellator in a day-case setting.

Methods

From 2004 to 2008, 137 men were treated with an 80W holmium:YAG laser and subsequent tissue morcellation.

Results

The average patient age was 68.0±7.1 (51–86) years. Morcellation time was 8.6±6.8 (1–35) min. The weight of the resected tissue was 36.6±30.0 (2–175) g. The total time for the procedure was 69.6±28.7 (29–150) min, and the efficiency of morcellation was 5.0±2.6 (0.2–11.5) g/min. The complication rate due to morcellation was 4.3%.

Conclusion

HoLEP with mechanical morcellation is safe even in a day-case setting. The total procedure time approximates that for TURP, so a longer theatre time loses significance as an argument against the method. Complications are rare and not severe. Further technical improvement is desirable.

Keywords

HoLEP Morcellation Day-case BPH Laser 

Notes

Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehung hin: Der Autor hat an der klinischen Erprobung der Morcellators mitgewirkt. Trotz des möglichen Interessenkonflikts ist der Beitrag unabhängig und produktneutral.

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Copyright information

© Springer Medizin Verlag 2009

Authors and Affiliations

  1. 1.Urologisches Zentrum NeustadtNeustadt/Weinstr.Deutschland

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