Skip to main content

Advertisement

SpringerLink
Log in

Laparoscopic adenomectomy versus Eraser laser enucleation of the prostate

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate functional outcomes and morbidity rates after laparoscopic adenomectomy (LA) and Eraser laser enucleation of the prostate (ELEP).

Materials and methods

Forty patients with lower urinary tract symptoms suggesting bladder outlet obstruction, with a prostate heavier than 70 g on transrectal ultrasound, were selected to undergo laparoscopic adenomectomy or Eraser laser enucleation of the prostate. All patients were consecutively enrolled without randomization and assessed preoperatively, 3 and 6 months postoperatively. Baseline characteristics, perioperative data, and postoperative outcomes were compared.

Results

The total operating time was significantly longer in the LA group (138.8 ± 11.4 vs. 78.4 ± 10.0 min, p < 0.000001). Catheter removal was performed earlier (61.2 ± 21.3 vs. 174.0 ± 13.2 h, p < 0.000001) and the hospital stay was significantly shorter (62.4 ± 21.2 vs. 187.2 ± 12.6 h, p < 0.000001) in the ELEP group. The latter group experienced significantly less perioperative hemoglobin (Hb) loss (0.71 ± 0.25 vs. 2.15 ± 1.08 g/dl, p < 0.000001), and their postoperative Hb levels (14.1 ± 1.21 vs. 11.7 ± 1.31 g/dl, p < 0.000001) were significantly higher. The resected tissue was significantly greater in the LA group (58.5 ± 23.3 vs. 87.9 ± 22.4 g, p = 0.0002). Significant improvements in Qmax, Qol, and symptom scores from baseline to each follow-up time point were noted in both groups. No statistically significant difference in symptom scores or Qmax was registered between the LA and the ELEP group throughout the follow-up period.

Conclusion

Laparoscopic adenomectomy and ELEP were equally effective for relieving bladder outflow obstruction and lower urinary tract symptoms. The advantages of ELEP include less blood loss, shorter catheterization times, and shorter hospital stays.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Varkarakis L, Kyriakakis Z, Delis A, Protogerou V, Deliveliotis C (2004) Long-term results of open transvesical prostatectomy from a contemporary series of patients. Urology 64(2):306–310

    Article  PubMed  Google Scholar 

  2. McCullough TC, Heldwein FL, Soon SJ et al (2009) Laparoscopic versus open simple prostatectomy: an evaluation of morbidity. J Endourol 23(1):129–133

    Article  PubMed  Google Scholar 

  3. Porpiglia F, Terrone C, Renard J et al (2006) Transcapsular adenomectomy (Millin): a comparative study, extraperitoneal laparoscopy versus open surgery. Eur Urol 49(1):120–126

    Article  PubMed  Google Scholar 

  4. Baumert H, Ballaro A, Dugardin F, Kaisary AV (2006) Laparoscopic versus open simple prostatectomy: a comparative study. J Urol 175(5):1691–1694

    Article  CAS  PubMed  Google Scholar 

  5. Kuntz RM, Lehrich K, Ahyai SA (2008) Holmium laser enucleation of the prostate versus open prostatectomy for prostates greater than 100 grams: 5-year follow-up results of a randomised clinical trial. Eur Urol 53:160–166

    Article  PubMed  Google Scholar 

  6. Rolle A, Pereszlenyi A, Koch R et al (2006) Laser resection technique and results of multiple lung metastasectomies using a new 1,318 nm Nd: YAG laser system. Lasers Surg Med 38:26

    Article  PubMed  Google Scholar 

  7. Lusuardi L, Myatt A, Sieberer M et al (2011) Safety and efficacy of Eraser laser enucleation of the prostate: preliminary report. J Urol 186:1967–1971

    Article  PubMed  Google Scholar 

  8. Hruby S, Sieberer M, Schätz T et al (2013) Eraser laser enucleation of the prostate: technique and results. Eur Urol 63(2):341–346

    Article  PubMed  Google Scholar 

  9. Ahyai SA, Lehrich K (2007) Kuntz RM Holmium laser enucleation versus transurethral resection of the prostate: 3-year follow-up results of a randomized clinical trial. Eur Urol 52:1456–1463

    Article  PubMed  Google Scholar 

  10. Eltabey MA, Sherif H, Hussein AA (2010) Holmium laser enucleation versus transurethral resection of the prostate. Can J Urol 17:5447–5452

    PubMed  Google Scholar 

  11. Gilling PJ, Wilson LC, King CJ, Westenberg AM, Frampton CM, Fraundorfer MR (2012) Long-term results of a randomized trial comparing holmium laser enucleation of the prostate and transurethral resection of the prostate: results at 7 years. BJU Int 109:408–411

    Article  PubMed  Google Scholar 

  12. Gupta N, Sivaramakrishna KR, Dogra PN, Seth A (2006) Comparison of standard transurethral resection, transurethral vapour resection and holmium laser enucleation of the prostate for managing benign prostatic hyperplasia of >40 g. BJU Int 97:85–89

    Article  PubMed  Google Scholar 

  13. Mavuduru RM, Mandal AK, Singh SK et al (2009) Comparison of HoLEP and TURP in terms of efficacy in the early postoperative period and perioperative morbidity. Urol Int 82:130–135

    Article  CAS  PubMed  Google Scholar 

  14. Montorsi F, Naspro R, Salonia A et al (2004) Holmium laser enucleation versus transurethral resection of the prostate: results from a 2-center, prospective, randomized trial in patients with obstructive benign prostatic hyperplasia. J Urol 172:1926–1929

    Article  PubMed  Google Scholar 

  15. Salonia A, Suardi N, Naspro R et al (2006) Holmium laser enucleation versus open prostatectomy for benign prostatic hyperplasia: an inpatient cost analysis. Urology 68:302–306

    Article  PubMed  Google Scholar 

  16. Kuntz RM (2006) Current role of lasers in the treatment of benign prostatic hyperplasia (BPH). Eur Urol 49:961–969

    Article  PubMed  Google Scholar 

  17. Tan AH, Gilling PJ, Kennett KM, Frampton C, Westenberg AM, Fraundorfer MR (2003) A randomized trial comparing holmium laser enucleation of the prostate with transurethral resection of the prostate for the treatment of bladder outlet obstruction secondary to benign prostatic hyperplasia in large glands (40 to 200 grams). J Urol 170:1270–1274

    Article  CAS  PubMed  Google Scholar 

  18. Chen YB, Chen Q, Wang Z et al (2013) A prospective, randomized clinical trial comparing plasmakinetic resection of the prostate with holmium laser enucleation of the prostate based on a 2-year followup. J Urol 189:217–222

    Article  PubMed  Google Scholar 

  19. Oelke M, Bachmann A, Descazeaud A et al (2013) EAU guidelines on the treatment and follow-up of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. Eur Urol 64:118–140

    Article  PubMed  Google Scholar 

  20. Herrmann TR, Bach T, Imkamp F et al (2010) Thulium laser enucleation of the prostate (ThuLEP): transurethral anatomical prostatectomy with laser support. Introduction of a novel technique for the treatment of benign prostatic obstruction. World J Urol 28(1):45–51

    Article  PubMed  Google Scholar 

  21. Zhang F, Shao Q, Herrmann TR, Tian Y, Zhang Y (2012) Thulium laser versus holmium laser transurethral enucleation of the prostate: 18-month follow-up data of a single center. Urology 79(4):869–874

    Article  PubMed  Google Scholar 

  22. Paweł Świniarski P, Stępień S, Dudzic W, Kęsy S, Blewniewski M, Różański W (2012) Thulium laser enucleation of the prostate (TmLEP) vs. transurethral resection of the prostate (TURP): evaluation of early results. Cent European. J Urol 65(3):130–134

    Google Scholar 

  23. Iacono F, Prezioso D, Di Lauro G et al (2012) Efficacy and safety profile of a novel technique, ThuLEP (Thulium laser enucleation of the prostate) for the treatment of benign prostate hypertrophy. Our experience on 148 patients. BMC Surg 12(Suppl 1):21

    Article  Google Scholar 

  24. Wezel F, Wendt-Nordahl G, Huck N et al (2010) New alternatives for laser vaporization of the prostate: experimental evaluation of a 980-, 1,318- and 1,470-nm diode laser device. World J Urol 28(2):181–186

    Article  PubMed  Google Scholar 

  25. Mariano MB, Graziottin TM, Tefilli MV (2002) Laparoscopic prostatectomy with vascular control for benign prostatic hyperplasia. J Urol 167(6):2528–2529

    Article  PubMed  Google Scholar 

  26. McCullough TC, Heldwein FL, Soon SJ, Galiano M, Barret E, Cathelineau X et al (2009) Laparoscopic versus open simple prostatectomy: an evaluation of morbidity. J Endourol 23(1):129–133

    Article  PubMed  Google Scholar 

  27. Barret E, Bracq A, Braud G et al (2006) The morbidity of laparoscopic versus open simple prostatectomy. Eur Urol Suppl 5:274

    Article  Google Scholar 

  28. Peltier A, Hoffmann P, Hawaux E, Entezari K, Deneft F, van Velthoven R (2007) Laparoscopic extraperitoneal Millin’ s adenomectomy versus open retropubic adenomectomy: a prospective comparison. Eur Urol Suppl 6:163

    Article  Google Scholar 

  29. Hoepffner JL, Gaston R, Piechaud T et al (2006) Finger assisted laparoscopic retropubic prostatectomy (Millin). Eur Urol Suppl 5:962–967

    Article  Google Scholar 

  30. Asimakopoulos AD, Mugnier C, Hoepffner JL et al (2012) The surgical treatment of a large prostatic adenoma: the laparoscopic approach-a systematic review. Endourol 26(8):960–967

    Article  Google Scholar 

Download references

Conflict of interest

All of the authors declare that they have no conflict of interest with the current manuscript.

Ethical standard

The present manuscript has been approved by the appropriate ethics committee and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All persons gave their informed consent prior to their inclusion in the study.

Author information

Author notes

    Authors and Affiliations

    1. Department of Urology and Andrology, Paracelsus Medical University Salzburg, Müllner Hauptstraße 48, 5020, Salzburg, Austria

      L. Lusuardi, S. Hruby, G. Janetschek, M. Mitterberger, M. Sieberer, D. Colleselli, T. Kunit & B. Kloss

    2. Research Office, Biostatistics, Paracelsus Medical University, Salzburg, Austria

      W. Hitzl

    Authors
    1. L. Lusuardi
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. S. Hruby
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. G. Janetschek
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. M. Mitterberger
      View author publications

      You can also search for this author in PubMed Google Scholar

    5. M. Sieberer
      View author publications

      You can also search for this author in PubMed Google Scholar

    6. D. Colleselli
      View author publications

      You can also search for this author in PubMed Google Scholar

    7. T. Kunit
      View author publications

      You can also search for this author in PubMed Google Scholar

    8. W. Hitzl
      View author publications

      You can also search for this author in PubMed Google Scholar

    9. B. Kloss
      View author publications

      You can also search for this author in PubMed Google Scholar

    Corresponding author

    Correspondence to L. Lusuardi.

    Additional information

    Lukas Lusuardi and Birgit Kloss contributed equally to the investigation and the report.

    Rights and permissions

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Lusuardi, L., Hruby, S., Janetschek, G. et al. Laparoscopic adenomectomy versus Eraser laser enucleation of the prostate. World J Urol 33, 691–696 (2015). https://doi.org/10.1007/s00345-014-1476-1

    Download citation

    • Received:

    • Accepted:

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1007/s00345-014-1476-1

    Keywords

    Search

    Navigation