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Endoscopic enucleation for prostate larger than 60 mL: comparison between holmium laser enucleation and plasmakinetic enucleation

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Abstract

Purpose

To compare perioperative and functional outcomes of two different energy sources, holmium laser and bipolar current for endoscopic enucleation of prostate larger than 60 mL.

Methods

A prospective, monocentric, comparative, non-randomized study was conducted including all patients treated for prostate larger than 60 mL, measured by transrectal ultrasound. Patients were assigned to each group based on the surgeons' practice. Perioperative data were collected (preoperative characteristics, operating, catheterization and hospitalization times, hemoglobin loss, complications) and functional outcomes (IPSS, IPSS Quality of Life (QoL), PSA) at 3 months and 1 year.

Results

100 patients were included in each group from October 2015 to March 2018. No differences between HoLEP and plasma groups were observed at baseline, except for mean IPSS score, IPSS QoL score and preoperative PVR that were significantly higher in the HoLEP group. Operating time (142.1 vs 122.4 min; p = 0.01), catheterization time (59.6 vs 44.4 h; p = 0.01) and hospitalization time (2.5 vs 1.8 days; p = 0.02) were significantly shorter in the plasma group. Complication and transfusion rate were no significantly different between HoLEP and plasma. No significant differences were observed concerning functional outcomes at 3 months and 1 year. The urinary incontinence rate was higher 21.1% vs 6.4% (p < 0.01) at 3 months in HoLEP group, but no difference was observed at 1 year.

Conclusion

Holmium and plasma are both safe and effective for endoscopic treatment for prostate larger than 60 mL. Operating, catheterization and hospitalization times were significantly shorter in the plasma group. The complication rate and functional outcomes were not significantly different.

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Authors and Affiliations

  1. Department of Urology, Andrology and Renal Transplantation, CHU Rangueil, Paul-Sabatier University, 1 Avenue J Poulhès, 31059, Toulouse Cedex, France

    P.- M. Patard, M. Roumiguie, E. Huyghe, M. Soulié, B. Malavaud, X. Gamé & P. Rischmann

  2. Department of Urology, Clinique du Pont de Chaume, 330 Avenue Marcel Unal, Montauban, France

    S. Sanson

  3. Department of Urology, Saint Jean Languedoc/La Croix du Sud Hospital, Toulouse, France

    J.- B. Beauval

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Contributions

PM Patard: Project development, Data analysis, Manuscript writing. M Roumiguie: Data collection, Management. S Sanson: Data collection. JB Beauval: Data collection. E Huyghe: Data collection. M Soulie: Data collection. B Malavaud: Data collection. X Game: Data collection, Manuscript editing. P Rischmann: Data collection, Manuscript editing.

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Correspondence to P.- M. Patard.

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Patard, P.M., Roumiguie, M., Sanson, S. et al. Endoscopic enucleation for prostate larger than 60 mL: comparison between holmium laser enucleation and plasmakinetic enucleation. World J Urol 39, 2011–2018 (2021). https://doi.org/10.1007/s00345-020-03382-x

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  • DOI: https://doi.org/10.1007/s00345-020-03382-x

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