Abstract
Introduction:
Decisions on benign prostatic enlargement management are becoming increasingly complex because of the availability of various treatment modalities. Urolift is one such option, offered for patients with small-to-moderate (<80 cc) glands, particularly those wishing to preserve sexual function. Greenlight laser prostatectomy (GLLP) may also be offered for similarly sized prostates and is gaining popularity ahead of transurethral resection of prostate. With reintervention rates between 5% and 14% for Urolift, we present video footage from the case of a patient who underwent a GLLP subsequent to a previous Urolift.
Scenario:
A 62-year-old man underwent a Urolift for troublesome lower urinary tract symptoms (LUTS), at a previous National Health Service Trust, a year before presenting locally with progression of symptoms. He was diagnosed with low-pressure chronic retention and underwent a GLLP after prostate volume assessment.
Results:
The patient underwent an effective day-case GLLP and passed his trial removal of catheter 5 days later. We present an operative video of the steps, as a point of technique for removal of Urolift implants in such patients. The steps include formation of anterior channels after initial cystoscopy, followed by lateral lobe vaporization. Prior knowledge of implant position enables safe lasing of the suture (not the clip) and release of the implant, which is washed out at the end of the operation.
Conclusion:
GLLP is a viable and safe option for refractory LUTS post-Urolift. The implants do not impede the laser energy and, with knowledge of where they are typically placed, are explanted with relative ease.
The authors have no commercial associations during the past 3 years that might create a conflict of interest in connection with the video.
Authors have received and archived patient consent for video recording/publication in advance of video recording of procedure.
Runtime of video: 01 mins 27 secs
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