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En bloc enucleation technique during holmium laser enucleation of the prostate: An analysis of its efficiency
Author(s) -
Whiting Danielle,
Penev Branimir,
Ijaaz Anam,
Guest Katherine,
Cynk Mark
Publication year - 2021
Publication title -
luts: lower urinary tract symptoms
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.451
H-Index - 15
eISSN - 1757-5672
pISSN - 1757-5664
DOI - 10.1111/luts.12379
Subject(s) - enucleation , prostate , medicine , urology , demographics , surgery , nuclear medicine , cancer , demography , sociology
Objective Despite the acknowledgment that holmium laser enucleation of the prostate (HoLEP) is a safe, efficacious procedure with benefits over traditional treatments, it is not widely adopted. Its steep learning curve is considered responsible, and the new en bloc technique (EBT) aims to improve this. Methods A retrospective analysis of 268 consecutive patients (215 lobe technique [LT] and 53 EBT) who underwent HoLEP between May 2016 and April 2020 was performed. Data were collected on patient demographics, prostate volume, enucleation time, prostatic weight, and length of stay. Results There was no difference in mean prostate volume and enucleated prostatic weight between the LT and EBT (99.2 mL vs 98.5 mL, P = .95216, and 71.7 g vs 69.3 g, P = .92034, respectively). There was a reduction in mean enucleation time with the EBT to 37.7 minutes compared with 53.3 minutes (LT) ( P < .00001). This translated to an improved operative efficiency of 1.84 g/min (EBT) compared to 1.33 g/min (LT) ( P < .00001). The EBT demonstrated a continuous improvement in operative efficiency with increasing prostate size unlike the LT where efficiency plateaus. Conclusions The EBT for HoLEP demonstrates a significant improvement in operative efficiency which has the potential to reduce the surgeons’ learning curve and lead to more widespread adoption.