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Abstract

Purpose:

We modified the conventional morcellation procedure for holmium laser enucleation of the prostate (HoLEP), and its outcomes are presented in this article.

Materials and Methods:

As 395 patients were included, the conventional morcellation procedure was performed in the first 100 cases (group 1, cases 1–100), and an improved procedure was used in the last 100 cases (group 2, cases 296–395). The improved morcellation process has three steps to execute. The morcellation time, collected tissue weight, morcellation rate, and associated complications were recorded.

Results:

The tissue-resected weight was similar between group 1 (60.7±33.9 g) and group 2 (62.4±36.8 g). The mean morcellation time in group 1 was greater than that in group 2 (11.3±7.1 and 8.3±4.1 minutes, respectively), and the mean morcellation rate was better in group 2 than in group 1 (5.75±1.7 g/minutes in group 1 v 7.3±1.1 g/minutes in group 2). Complications, such as bladder injury, were similar in both groups.

Conclusion:

The improved morcellation procedure described in this article can be used in various situations of suction and can be performed in a more fluent manner and with better efficiency.

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References

Fraundorfer

, Gilling

. Holmium:YAG laser enucleation of the prostate combined with mechanical morcellation: preliminary results. Eur Urol, 1998; 33:69–72.

Gilling

et al. Holmium laser enucleation of the prostate (HoLEP) combined with transurethral tissue morcellation: an update on the early clinical experience. J Endourol, 1998; 12:457–459.

Hochreiter

et al. Holmium laser enucleation of the prostate combined with electrocautery resection: the mushroom technique. J Urol, 2002; 168,4 Pt 1:1470–1474.

Ahyai

, Lehrich

, Kuntz

. Holmium laser enucleation versus transurethral resection of the prostate: 3-year follow-up results of a randomized clinical trial. Eur Urol, 2007; 52:1456–1463.

Kuo

et al. Holmium laser enucleation of the prostate: morbidity in a series of 206 patients. Urology, 2003; 62:59–63.

Krambeck

, Handa

, Lingeman

. Holmium laser enucleation of the prostate for prostates larger than 175 grams. J Endourol, 2010; 24:433–437.

Shah, HN, et al. Influence of prostate size on the outcome of holmium laser enucleation of the prostate. BJU Int, 2008; 101:1536–1541.

Hwang

, Park

, Lee

. Holmium laser enucleation of the prostate for benign prostatic hyperplasia: effectiveness, safety, and overcoming of the learning curve. Korean J Urol, 2010; 51:619–624.

Ishikawa

et al.

[Relationship between morcellation efficiency and enucleated tissue weight in holmium laser enucleation of the prostate (HoLEP) for patients with benign prostatic hyperplasia]

Nihon Hinyokika Gakkai Zasshi, 2011; 102:675–678.

10.

Montorsi

et al. 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, 2004; 172,5 Pt 1:1926–1969.

11.

Vavassori

et al. Holmium laser enucleation of the prostate combined with mechanical morcellation: two years of experience with 196 patients. J Endourol, 2004; 18:109–112.

12.

Kim

et al. Holmium laser enucleation of the prostate: a comparison of efficiency measures at two institutions. J Endourol, 2005; 19:555–558.

13.

Seki

, Tatsugami

, Naito

. Holmium laser enucleation of the prostate: comparison of outcomes according to prostate size in 97 Japanese patients. J Endourol, 2007; 21:192–196.

14.

Elzayat

, Elhilali

. Holmium laser enucleation of the prostate (HoLEP): long-term results, reoperation rate, and possible impact of the learning curve. Eur Urol, 2007; 52:1465–1471.

15.

Vavassori

et al. Three-year outcome following holmium laser enucleation of the prostate combined with mechanical morcellation in 330 consecutive patients. Eur Urol, 2008; 53:599–604.

16.

et al. Holmium laser enucleation of the prostate: the safety, efficacy, and learning experience in China. J Endourol, 2008; 22:1031–1036.

17.

Tan