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Comparison Between 1-Day and Inpatient Procedure of Holmium Laser Enucleation in Patients With Benign Prostate Hyperplasia
摘要： Holmium laser enucleation of the prostate (HoLEP) is one of the minimally invasive procedures that is used for patients with benign prostate hyperplasia. The procedure usually requires patients to stay in the hospital 2 nights or longer. The present study evaluated the safety and feasibility of HoLEP with discharge of the patients on Day 1 after surgery (1-day surgery). A total of 1,164 patients were included in the study, with 510 of them planned for 1-day surgery and others planned for inpatient surgery. The primary outcomes included complication rate and clinical outcomes. A total 489 out of 510 patients received 1-day HoLEP and were discharged on Day 1 after surgery. In a 30-day follow-up period, no significant differences were found between the 1-day and inpatient surgery groups in terms of the rate of complications and clinical outcomes. Patients in the 1-day surgery group had a significantly shorter waiting time for admission (9.5 ± 4.8 vs. 17.6 ± 7.4 days, p < .05), and the mean hospitalization cost was lower (CNY$ 9140.6 ± 1452.2 vs. 10533.4 ± 1594, p < .05).The 1-day HoLEP surgery was safe and had satisfactory clinical outcomes. This treatment strategy could reduce the waiting time for admission and cost of hospitalization. Majority of the patients found this 1-day surgery beneficial, especially elderly patients who prefer to have an early return home and rapid resumption of activities.
关键词： holmium laser enucleation of the prostate,benign prostate hyperplasia,lower urinary tract symptoms,1-day surgery
更新于2025-09-12 10:27:22
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Determination of prostate cancer marker Zn2+ with a highly selective surface-enhanced Raman scattering probe on liquid–liquid self-assembled Au nanoarrays
摘要： As the concentration of Zn2+ in patients with prostate cancer is much less than that in healthy persons, Zn2+ concentration can be used as a marker to expediently screen prostate cancer. In this study, a sensitive and highly selective surface-enhanced Raman scattering (SERS) method to detect Zn2+ concentration in human prostatic fluids by utilizing water-insoluble 2-carboxyl-2′-hydroxyl-5′-sulfoformazylbenze (Zincon) as a SERS probe based on self-assembled Au nanoarrays at a liquid–liquid interface between n-hexane and Au colloids was proposed. Zincon showed remarkably different SERS bands before and after coordinating Zn2+ in the controlled conditions (70 μL of ethanol, 500 μL of n-hexane, pH value of 7.1 and 10 s of vortex mixing time), which can be used in quantifying Zn2+ with characteristic peaks. The proposed SERS method presented a good linear relationship ranging from 0.5 to 10 μmol/L and a satisfactory detection limit of 0.1 μmol/L as well as low interference with other metal ions. Moreover, the detection results are close to those of the conventional standard atomic absorption spectroscopy (AAS) method.
关键词： SERS,Au nanoarray,Zincon,Zn2+,Liquid-liquid self-assembly,Prostate cancer
更新于2025-09-12 10:27:22
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Holmium laser enucleation versus bipolar plasmakinetic enucleation of a large volume benign prostatic hyperplasia: a randomised controlled trial
摘要： Objectives: To compare safety and efficacy of bipolar plasmakinetic enucleation (BPEP) versus holmium laser enucleation (HoLEP) for management of large BPH (>80gm). Patients and methods: Patients with failed medical treatment, International Prostate Symptom Score (IPSS)>13, peak urinary flow rate (Qmax)<15ml/sec and prostate size ≥80gm were enrolled in this randomised controlled trial from from November 2016 to February 2018 and managed by HoLEP (Group A; 33patients) or BPEP (Group B; 31patients). Patients on anticoagulants were not excluded. Patients were followed‐up for 12 months. Perioperative data was compared between both groups using Student‐t, Mann‐Whitney, Paired‐t, Wilcoxon signed rank, Chi‐Square, or Fisher‐Exact tests as appropriate. Results: There was no significant difference between both groups in age, rate of presentation with urinary retention, recurrent hematuria, frequency of patients on anticoagulants/antiplatelets, prostate size, PSA, Qmax, IPSS, quality of life (QoL) and post‐void residual urine (PVRU). Operative time was significantly longer in BPEP (p=0.003) as well as catheterization duration (p=0.019). Other perioperative parameters including level of Na+ and hemoglobin, resected tissue weight, hospital stay and complications were not significantly different between both groups. There was no need for blood transfusion in all patients. There was significant postoperative improvement in IPSS, PVRU, QoL, PSA and Qmax in each group. However, there was no significant difference between both groups in these parameters. Conclusion: HoLEP and BPEP are comparable regarding safety and efficacy for treatment of BPH (>80gm) including patients on anticoagulants. However, BPEP required a longer catheterization duration and operative time.
关键词： TURP,Plasmakinetic enucleation,Large volume prostate,BPH,anticoagulants,HoLEP
更新于2025-09-12 10:27:22
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Current surgical techniques of enucleation in holmium laser enucleation of the prostate
摘要： Holmium laser enucleation of the prostate (HoLEP) has been accepted as the most efficient method of transurethral surgery for benign prostatic hyperplasia. The originally developed three-lobe technique has popularized this surgery; this method is based on three longitudinal incisions, by which the median lobe is removed, and subsequently, both lateral lobes are enucleated. To maintain a consistent surgical plane and to minimize sphincteric damage, the traditional three-lobe technique is continuously being refined and evolving. A few modifications of the original technique have been developed, and several en bloc enucleation methods have been introduced. However, more clinical evidence is required to show the superiority of newer techniques over the original three-lobe technique in terms of efficacy and long-term side effects. To date, none of the newer techniques have been accepted as a standard technique for HoLEP.
关键词： Enucleation,Laser therapy,Prostatic hyperplasia,Transurethral resection of prostate,Holmium
更新于2025-09-12 10:27:22
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Transperineal laser ablation for percutaneous treatment of benign prostatic hyperplasia: a feasibility study. Results at 6 and 12 months from a retrospective multi-centric study
摘要： Purpose To investigate the effectiveness and safety of SoracteLite?—transperineal percutaneous laser ablation (TPLA) in the treatment of patients with symptomatic benign prostatic hyperplasia (BPH) at 6 and 12 months follow-up. Methods Patients with urinary symptoms secondary to BPH underwent TPLA under local anesthesia in four centers. Under US guidance, up to four 21G applicators were inserted in the prostatic tissue. Each treatment was performed with diode laser operating at 1064 nm changing the illumination time according to prostate size. The primary end-points of this study were change in IPSS, PVR, Qmax, QoL, and prostatic volume at 6 an 12 months from SoracteLiteTM TPLA treatment. Secondary end-point was the assessment of complications. Results Analysis was performed on data 160 patients (mean age 69.8 ± 9.6 years) with at least 6 months follow and of 83 patients (mean age 67.9 ± 8.7 years) with at least 12 months follow-up. At 6 months, IPSS improved from 22.5 ± 5.1 to 7.7 ± 3.3 (P < 0.001), PVR from 89.5 ± 84.6 to 27.2 ± 44.5 ml (P < 0.001), Qmax from 8.0 ± 3.8 to 14.3 ± 3.9 ml/s (P < 0.001), QoL from 4.5 ± 1.1 to 1.8 ± 1.0 (P < 0.001), volume from 75.0 ± 32.4 to 60.3 ± 24.5 ml (P < 0.001). At 12 months, IPSS improved from 22.5 ± 4.5 to 7.0 ± 2.9 (P < 0.001), PVR from 71.7 ± 93.9 to 17.8 ± 51.0 ml (P < 0.001), Qmax from 8.6 ± 5.2 to 15.0 ± 4.0 ml/s (P < 0.001), QoL from 4.2 ± 0.6 to 1.6 ± 0.9 (P < 0.001), volume from 87.9 ± 31.6 to 58.8 ± 22.9 ml (P < 0.001). 7/160 (4.3%) grade I and 1/160 (0.6%) grade III complication occurred. Conclusions SoracteLite? TPLA allows signi?cant improvement of IPSS, Qol, Qmax, PVR, and reduction of prostatic volume at 6 and 12 months.
关键词： Minimally invasive therapy,Benign prostatic hyperplasia,Laser ablation,Transperineal laser ablation,Prostate treatment
更新于2025-09-12 10:27:22
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Polydopamine nanospheres loaded with l-cysteine-coated cadmium sulfide quantum dots as photoelectrochemical signal amplifier for PSA detection
摘要： A sandwich-type photoelectrochemical (PEC) immunosensor was constructed for sensitive detection of prostate specific antigen (PSA). It was based on electrochemically reduced graphene oxide-TiO2 (ERGO-TiO2) as photoelectrochemical platform to immobilize capture antibody (Ab1). Then, quinone-rich polydopamine nanospheres (PDANS) loaded detection antibody (Ab2) and photocurrent signal label, L-cysteine-coated cadmium sulfide quantum dots (CdSQDs). ERGO-TiO2 displayed greatly improved photocurrent response to white light. CdSQDs conjugated with PDANS further amplified photocurrent signal because of the good conductivity of PDANS and ERGO. The increased photocurrent showed a linear correlation with PSA in the concentration range from 0.02 pg mL?1 to 200 ng mL?1 with the detection limit of 6.8 fg mL?1. It also revealed high selectivity and good stability.
关键词： Electrochemically reduced graphene oxide-TiO2,Polydopamine nanospheres,Photoelectrochemical immunosensor,L-cysteine-coated cadmium sulfide quantum dots,Prostate specific antigen
更新于2025-09-12 10:27:22
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Mind the Gaps: Adoption and Underutilization of Holmium Laser Enucleation of the Prostate (HoLEP) in the United States from 2008-2014
摘要： There is increasing recognition of the advantages of Holmium Laser Enucleation of the Prostate (HoLEP) for Benign Prostatic Hypertrophy (BPH) treatment In the United States (U.S.) but relatively little is known about the extent of HoLEP adoption over time. This study aims to assess national HoLEP adoption rates and regional trends from 2008‐2014. Methods: We retrospectively analyzed a dataset of 100% Medicare claims to determine the rate of U.S. HoLEP adoption in 2008, 2011 and 2014. Rates were adjusted by age and race and stratified by Hospital Referral Region (HRR). Linear and logistic regression models were used to assess for trends in HoLEP adoption over time. Results: Total U.S. BPH cases decreased 24% from 2008‐2014 and HoLEP cases increased significantly from 1086 (2008) to 3368 (2014). Despite this, HoLEP accounted for just 4% of total BPH cases in 2014. In 2008 28/306 (9%) of HRRs recorded >10 HoLEPs/year. This increased to 89 HRRs (29%) in 2011 but stabilized at 94 HRRs (31%) in 2014. In 2014, over 50% of states still had only 0‐1 sites doing 10+ HoLEPs/year. Conclusions: Based on this 100% sample of Medicare claims from 2008‐2014, surgical BPH treatment volume has decreased while HoLEP volume and regional adoption have tripled. However, rates of HoLEP remain extremely low at just 4% of all BPH procedures in 2014 and large regional gaps in care exist. This data indicates that HoLEP remains substantially under‐ utilized and the majority of regions still lack access to centers performing >10 HoLEPs/year.
关键词： lasers/supply & distribution,transurethral resection of prostate/trends,benign prostatic hyperplasia,prostatic hyperplasia/surgery
更新于2025-09-12 10:27:22
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Standardization of 532 nm Laser Terminology for Surgery in Benign Prostatic Hyperplasia (BPH): A Systematic Review
摘要： Introduction: The use of GreenLight? laser technology to remove the prostatic transitional zone (TZ) transurethrally has grown considerably in recent years, and with it an increase in the number of terms that are used to describe similar techniques. Varying terminology complicates literature analysis and publication, which can cause confusion when performing reviews of the literature. It has become necessary to simplify and standardize terminology used to describe transurethral prostate debulking procedures using the 532 nm laser in order to simplify communication on these techniques. Materials and Methods: We conducted a search on September 17th, 2019 in the following databases: Ovid MEDLINE?; Ovid EMBASE; and PubMed. Results: Of the 1115 unique records found in our database search, a total of 27 articles were selected for inclusion. Of the 16 search terms used, we found that 4 terms could be used to describe the fundamental technique associated with each search term. These terms include “vaporization”, “vaporesection”, “vapoenucleation”, and “enucleation”. Conclusions: Standardizing terminology leads to an efficient consolidation of terms based on the above outcomes. This will streamline the literature search process for future publications and facilitate comparison of varying techniques.
关键词： vapoenucleation,enucleation,532 nm laser,vaporesection,prostate,terminology,benign prostatic hyperplasia,laser prostatectomy,vaporization,GreenLight laser
更新于2025-09-12 10:27:22
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Thulium Laser Enucleation of the Prostate: Median Lobe Enucleation, Step by Step, for a Beginner Surgeon
摘要： Introduction and Objectives: Since 2010, Herrmann and colleagues1 introduced thulium laser enucleation of the prostate (ThuLEP) as a versatile minimally invasive enucleation procedure, followed by number of studies that have con?rmed its feasibility and ef?cacy such as holmium laser enucleation of the prostate (HoLEP). Our aim is to present a self-taught, ThuLEP, learning curve for a single surgeon with no previous HoLEP2 experience. Methods: Between February and August 2018, a well-trained endourologist, who did not perform laser enucleation of the prostate before, started reviewing the available literature, attended >15 procedures at another hospital, and participated in 3 laser enucleation of prostate workshop. A total of 18 patients with prostate size between 80 and 120 g underwent ThuLEP for the ?rst time. We used Revolix DUO(cid:2) machine with a 40 watt setting for both cutting and coagulation with a 550lm ?ber for all cases. Results: In the ?rst four cases, the surgeon was unable to completely enucleate the ?rst lobe and ended with open prostatectomy. In the following four cases, one lobe was completely enucleated and morcellated, whereas the other lobe was ?nished by bipolar resection. The remaining cases were effectively enucleated and morcellated. All patients had a satisfactory voiding outcome with mean Qmax of 24.5 after surgery. Conclusion: ThuLEP extraordinary hemostatic effect and its limited penetration depth may allow it to be an appropriate start for a beginner surgeon, while the after effect charring outcome may mask the capsular outline and would be its major drawback that could be avoided with lower watt and limited incisions.
关键词： laser,prostate,enucleation,thulium
更新于2025-09-12 10:27:22
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Holmium laser enucleation of the prostate
摘要： According to the European Association of Urology guidelines [1], holmium laser enucleation of the prostate (HoLEP) is an established standard of care for patients suffering from lower urinary tract symptoms secondary to benign prostatic enlargement, causing bladder outlet obstruction refractory to medication. HoLEP was introduced in the late 1990s by P. J. Gilling and M. R. Fraundorfer, combining the mini-invasiveness of the transurethral approach and the ability to obtain endoscopically the same complete anatomic enucleation of the prostatic adenoma provided by open prostatectomy, with maximal outlet desobstruction. Over the years, HoLEP has been proven to be safe and effective for the treatment of prostatic adenomas of any size [2], also in patients on antiplatelet/anticoagulant therapies [3,4].
关键词： holmium laser enucleation of the prostate,benign prostatic enlargement,bladder outlet obstruction,lower urinary tract symptoms,HoLEP
更新于2025-09-12 10:27:22