Holmium Laser Enucleation of the Prostate (HoLEP): A Technical Update
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Holmium Laser Enucleation of the Prostate (HoLEP): A Technical Update Ramsay L Kuo*1, Ryan F Paterson1, Samuel C Kim1, Tibério M Siqueira Jr1, Mostafa M Elhilali2 and James E Lingeman1 Address: 1Methodist Hospital Institute for Kidney Stone Disease and Indiana University School of Medicine Indianapolis, Indiana, USA and 2The Department of Urology McGill University Faculty of Medicine Montreal, Quebec, Canada Email: Ramsay L Kuo* - [email protected]; Ryan F Paterson - [email protected]; Samuel C Kim - [email protected]; Tibério M Siqueira Jr - [email protected]; Mostafa M Elhilali - [email protected]; James E Lingeman - [email protected] * Corresponding author
Published: 6 June 2003 World Journal of Surgical Oncology 2003, 1:6
Received: 6 February 2003 Accepted: 6 June 2003
This article is available from: http://www.wjso.com/content/1/1/6 © 2003 Kuo et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.
Benign prostatic hyperplasiaHolmiumLasers
Abstract Introduction: Holmium laser enucleation of the prostate (HoLEP) combined with mechanical morcellation represents the latest refinement of holmium:YAG surgical treatment for benign prostatic hyperplasia (BPH). Utilizing this technique, even the largest of glands can be effectively treated with minimal morbidity. The learning curve remains an obstacle, preventing more widespread adoption of this procedure. This paper provides an outline of the HoLEP technique as is currently used at two centers in hopes of easing the initial learning curve. Technical considerations: Detailed descriptions of the major steps of the HoLEP procedure are provided with attention to critical steps such as identification of the surgical capsule, median and lateral lobe enucleation, and morcellation of enucleated tissue. Conclusions: HoLEP is a promising alternative for the surgical treatment of BPH which allows complete removal of intact lobes of the prostate. Obstruction is relieved immediately with superior hemostasis, no risk of TUR syndrome, and a minimal hospital stay.
Introduction Benign prostatic hyperplasia (BPH), which is prevalent in up to 43% of men over the age of 60[1], continues to be a leading cause of voiding difficulties. Symptoms generally worsen with age, with men experiencing a mean increase of the American Urological Association (AUA) symptom score of 0.18 points per year of follow-up[2] Although symptoms can often be handled adequately with medical therapy, patients who continue to suffer significant voiding problems will eventually require surgical intervention
to avoid or treat long-term sequelae such as urinary retention, urinary tract infections, and bladder calculi. When surgical treatment is considered, transurethral resection of the prostate (TURP) is still the standard to which all other modalities are compared. Although
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