Holmium Laser Enucleation Of The Prostate-Outcomes Independent Of Prostate Size?

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology
Article Date: 23 Nov 2008 - 0:00 PST

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UroToday.com - Holmium laser enucleation of the prostate (HoLEP) is emerging as the procedure of choice for men with BPH. This paper highlights the universal appeal of HoLEP for treating prostates of all sizes with excellent functional long-term outcomes and few complications.

In our large series, no patient has required a secondary procedure for re-growth of BPH - attesting to the completeness of adenoma removal and the lasting benefits of the operation. The characteristics of the holmium wavelength, normal saline irrigant, and hemostatic properties of the laser provide a desired safety profile for patients without all the risks of more traditional surgical procedures. In today's cost conscious environment it has become more difficult to rely on a single use technology. This principal has led to an explosion of applications for the daVinci Robotic Surgical System (Intuitive Surgical Inc, Sunnyvale CA) that was initially used in urology for laparoscopic radical prostatectomy. It is not uncommon to see centers now using the same system for radical cystectomy, pyleoplasty and partial nephrectomy, not to mention the adoption of the technology by other surgical subspecialties.

Laser systems are no different. When one has the option to purchase a multi-use laser that can be used for tissue ablation (stricture, tumor, adenoma), enulceation, resection, or lithotripsy, does it make sense to buy a single-use laser that can only be used for BPH? While the question is beyond the scope of this paper, it represents a reasonable fiscal consideration as we highlight one of a growing number of reports detailing the potential benefits of the holmium laser. Used to perform HoLEP, it is the treatment of choice for BPH, one of the most common afflictions in men today.

Written by James E. Lingeman, MD, and Mitchell R. Humphreys, MD, as part of Beyond the Abstract on UroToday.com.

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