Holmium laser enucleation of the prostate with Virtual Basket mode: faster and better control on bleeding

Department of Urology, ASST Valle Olona, Via Arnaldo da Brescia, 21052, Busto Arsizio, VA, Italy. gioboz@yahoo.it. ESUT, European Section for UroTechnology, Arnhem, Italy. gioboz@yahoo.it. Department of Urology, ASST Valle Olona, Via Arnaldo da Brescia, 21052, Busto Arsizio, VA, Italy. Department of Urology, Ospedale Policlinico e Nuovo Ospedale Civile S. Agostino Estense, University of Modena and Reggio Emilia, Modena, Italy. ESUT, European Section for UroTechnology, Arnhem, Italy. Department of Urology, Clinique Saint Augustin, Bordeaux, France. Department of Urology, SLK Kliniken, Heilbron, Germany. Department of Urology, Spital Limmattal, Schlieren, Switzerland. Department of Urology, Moscow State University, Moscow, Russia. Department of Urology, University of Patras, Patras, Greece. Department of Urology, Clinica Sant'Anna, Lugano, Switzerland.

BMC urology. 2021;21(1):28
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Abstract
BACKGROUND To compare clinical intra and early postoperative outcomes between conventional Holmium laser enucleation of the prostate (HoLEP) and Holmium laser enucleation of the prostate using the Virtual Basket tool (VB-HoLEP) to treat benign prostatic hyperplasia (BPH). METHODS This prospective randomized study enrolled consecutive patients with BPH, who were assigned to undergo either HoLEP (n = 100), or VB-HoLEP (n  = 100). All patients were evaluated preoperatively and postoperatively, with particular attention to catheterization time, operative time, blood loss, irrigation volume and hospital stay. We also evaluated the patients at 3 and 6 months after surgery and assessed maximum flow rate (Qmax), postvoid residual urine volume (PVR), the International Prostate Symptom Score (IPSS) and the Quality of Life score (QOLS). RESULTS No significant differences in preoperative parameters between patients in each study arm were found. Compared to HoLEP, VB-HoLEP resulted in less hemoglobin decrease (2.54 vs. 1.12 g/dl, P = 0.03) and reduced operative time (57.33 ± 29.71 vs. 42.99 ± 18.51 min, P = 0.04). HoLEP and VB-HoLEP detrmined similar catheterization time (2.2 vs. 1.9 days, P = 0.45), irrigation volume (33.3 vs. 31.7 l, P = 0.69), and hospital stay (2.8 vs. 2.7 days, P = 0.21). During the 6-month follow-up no significant differences in IPSS, Qmax, PVR, and QOLS were demonstrated. CONCLUSIONS HoLEP and VB-HoLEP are both efficient and safe procedures for relieving lower urinary tract symptoms. VB-HoLEP was statistically superior to HoLEP in blood loss and operative time. However, procedures did not differ significantly in catheterization time, hospital stay, and irrigation volume. No significant differences were demonstrated in QOLS, IPSS, Qmax and PVR throughout the 6-month follow-up. TRIAL REGISTRATION Current Controlled Trials ISRCTN72879639; date of registration: June 25th, 2015. Retrospectively registred.
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Language : eng
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