511509 511509 2013
TAU0010.1177/1756287213511509Therapeutic Advances in UrologyM Cynk
Therapeutic Advances in Urology
Review
Holmium laser enucleation of the prostate: a review of the clinical trial evidence
Ther Adv Urol 2014, Vol. 6(2) 62–73 DOI: 10.1177/ 1756287213511509 © The Author(s), 2013. Reprints and permissions: http://www.sagepub.co.uk/ journalsPermissions.nav
Mark Cynk
Abstract: Transurethral resection of the prostate (TURP) has remained the procedure of choice for the surgical treatment of bladder outflow obstruction for almost five decades, but holmium laser enucleation of the prostate (HoLEP) is now emerging as a challenger as the gold standard procedure. This review summarizes the evidence base for HoLEP, with particular reference to randomized, controlled (level 1) evidence.
Keywords: prostatic hyperplasia, laser therapy, treatment outcome, humans, holmium, male, review
Transurethral resection of the prostate (TURP) has remained the procedure of choice for the surgical treatment of bladder outflow obstruction secondary to benign prostatic enlargement (BPE) for almost five decades [Madersbacher and Marberger, 1999]. However, morbidity after TURP is significant, with reported rates of blood transfusion of approximately 8% [AUA Practice Guidelines Committee, 2003], hyponatraemia in up to 3% [Rassweiler et al. 2006], and a reoperation rate of 1% per year [Madersbacher Prostate Study Group, 2005]. Numerous operations have been developed to improve the outcomes and reduce the morbidity of transurethral prostatic surgery, but most have not stood the test of time, either due to patient dissatisfaction or lack of durability [Gilling et al. 1996]. For a procedure to rival and surpass TURP, it needs to be acceptable both to surgeons and patients. It must have a low complication rate and a low reoperation rate. It should be effective in relieving bladder outflow obstruction and ideally it should be cheap [Chandhoke, 1998]. The holmium laser is a pulsed solid state laser, with a wavelength of 2140 nm. This wavelength is strongly absorbed by water, making it ideal for safe use in an aqueous environment. The tissue effects depend on the energy of the laser beam and its interaction with tissue. For holmium laser enucleation of the prostate (HoLEP), 80–100 W of power are used, and delivered to the prostate using an end-firing bare laser fibre. The effect is
precise tissue cutting, with penetration of energy approximately 0.2 mm into prostatic tissue, simultaneous coagulation of blood vessels, and very little thermal spread. HoLEP was originally developed in Tauranga, New Zealand by Peter Gilling and Mark Fraundorfer [Gilling et al. 1996]. The first prostate procedures performed using the holmium laser were ablation procedures, but the surgeons found the technique unacceptably slow. By replacing a side-firing fibre with an end-firing fibre, the surgeons discovered that it was possible to cut away chips of prostate, so the procedure of holmium laser resection of the prostate evolved. Better still, a whole lobe of prostate could be enucleated along the anatomical plane between the adenoma and the prostatic capsule, similar to the principles used in open Millin’s or transvesical prostatectomy. For this development, a morcellator was required to allow efficient and safe removal of the enucleated prostate from within the bladder [Fraundorfer and Gilling, 1998].
Correspondence to: Mark Cynk, MB BS MSc FRCS(Urol) Consultant, Urological Surgeon, Maidstone and Tunbridge Wells NHS Trust, Maidstone Hospital, Hermitage Lane, Maidstone ME16 9QQ, UK [email protected]
This review aims to evaluate the evidence base for HoLEP, with particular reference to randomized, controlled (level 1A) evidence. Comparison with transurethral resection of the prostate There have been five randomized controlled trials comparing HoLEP with conventional TURP (Table 1). The original trial, performed
62 http://tau.sagepub.com
Downloaded from tau.sagepub.com at University of Otago Library on March 14, 2015
M Cynk Table 1. Randomized controlled trials of holmium laser encleation of the prostate (HoLEP) versus transurethral resection of the prostate (TURP).
Tan et al. [2003] Kuntz et al. [2004] Montorsi et al. [2004] Gupta et al. [2006] Eltabey et al. [2010]
HoLEP TURP HoLEP TURP HoLEP TURP HoLEP TURP HoLEP TURP
Patients (n)
Mean operation time (minutes)
Prostate removed (g)
Length of catheter use (days)
Qmax % change
PVR % change
IPSS % change
31 30 100 100 52 48 50 50 40 40
62.1 33.1* 94.6 73.8* 74.0 57.0* 75.4 62.6* 72.8 73.6
40.0* 24.7 32.6 37.2 36.1* 25.4 17.2 24.2* 44.2 37.4
0.7* 1.9 1.0* 2.0 1.3* 2.4 1.2* 2.0 1.5* 2.1
159 122 469 369 206 217 387 427 196 214
70 59 98* 88
83 79 92* 82 81 82 78 76 90* 85
82 76 95* 77
International Prostate Symptom Score, IPSS; PVR, postvoid residual; Qmax, maximum flow rate. *Significant difference P 60 g) prostate gland: plasmakinetic superpulse (bipolar) versus conventional (monopolar) transurethral resection of the prostate. J Endourol 23: 141–145. Chandoke, PS. and DeAntoni, E. (1998) Costeffectiveness analysis: Application to endourology. J Endourology 12: 485–491. Chen, Y., Chen, Q., Wang, Z. Peng, YB., Ma, LM., Zheng, DC. et al. (2013) A prospective, randomized clinical trial comparing plasmakinetic resection of the prostate with holmium laser enucleation of the prostate based on a 2-year followup. J Urol 189: 217–222. Herrmann, TRW., Liatsikos, EN., Nagele, U., Traxer, O., Merseburger, AS. (2012) EAU Guidelines Panel on Laser Technologies. EAU Guidelines on laser Technologies Eur Urol 61: 784–795. El-Hakim, A. and Elhilali, M. (2002) Holmium laser enucleation of the prostate can be taught: the first learning experience. BJU Int 90: 863–869.
http://tau.sagepub.com 71
Downloaded from tau.sagepub.com at University of Otago Library on March 14, 2015
Therapeutic Advances in Urology 6(2) Elmansy, H., Baazeem, A., Kotb, A. Badawy, H., Riad, E., Emran, A. et al. (2012) Holmium laser enucleation versus photoselective vaporization for prostatic adenoma greater than 60 ml: preliminary results of a prospective, randomized clinical trial. J Urol 188: 216–221. Eltabey, M., Sherif, H. and Hussein, A. (2010) Holmium laser enucleation versus transurethral resection of the prostate. Can J Urol 17: 5447-5452. Elzayat, E., Habib, E. and Elhilali, M. (2005) Holmium laser enucleation of the prostate: a size-independent new ‘gold standard’. Urology 66(5 Suppl.): 108–113. Fayad, A., Sheikh, M., Zakaria, T., Elfottoh, H. and Alsergany, R. (2011) Holmium laser enucleation versus bipolar resection of the prostate: a prospective randomized study. Which to choose? J Endourol 25: 1347–1352. Fraundorfer, M. and Gilling, P. (1998) Holmium:YAG laser enucleation of the prostate combined with mechanical morcellation: preliminary results. Eur Urol 33: 69–72. Fraundorfer MR., Gilling PJ., Kennett KM., Dunton NG. (2001) Holmium laser resection of the prostate is more cost effective than transurethral resection of the prostate: Results of a randomized prospective study. Urology 57: 454–458. Gilling, P., Aho, T., Frampton, C., King, C. and Fraundorfer, M. (2008) Holmium laser enucleation of the prostate: results at 6 years. Eur Urol 53: 744–749. Gilling, P., Cass, C., Cresswell, M., Malcolm, A. and Fraundorfer, M. (1996) The use of the holmium laser in the treatment of benign prostatic hyperplasia. J Endourol 10: 459–461. Gilling, P., Wilson, L., King, C., Westenberg, A., Frampton, C. and Fraundorfer, M. (2012) Long-term results of a randomized trial comparing holmium laser enucleation of the prostate and transurethral resection of the prostate: results at 7 years. BJU Int 109: 408–411. Gong, Y., He, D., Wang, M. Li, X., Zhu, G., Zheng, Z. et al. (2012) Holmium laser enucleation of the prostate: a modified enucleation technique and initial results. J Urol 187: 1336–1340. Gupta, N., Sivaramakrishna, Kumar, R., Dogra, P. and Seth, A. (2006) Comparison of standard transurethral resection, transurethral vapour resection and holmium laser enucleation of the prostate for managing benign prostatic hyperplasia of > 40 g. BJU Int 97: 85–89. Hochreiter, W., Thalmann, G., Burkhard, F. and Studer, U. (2002) Holmium laser enucleation of the prostate combined with electrocautery resection: the mushroom technique. J Urol 168: 1470–1474.
Humphreys, M., Miller, N., Handa, S., Terry, C., Munch, L. and Lingeman, J. (2008) Holmium laser enucleation of the prostate - outcomes independent of prostate size? J Urol 180: 2431-2435; discussion 2435. Hwang, J., Park, S. and Lee, J. (2010) Holmium laser enucleation of the prostate for benign prostatic hyperplasia: effectiveness, safety, and overcoming of the learning curve. Korean J Urol 51: 619–624. Kastner, C., Beard, R., Woodhams, S., Knight, O. and Popert, R. (2010) A journey of skills – theory and practice of a multi-modal approach to holmium laser prostatectomy. Br J Med Surg Urol 3: 160–166. Kim, S., Tinmouth, W., Kuo, R., Paterson, R. and Lingeman, J. (2004) Simultaneous holmium laser enucleation of prostate and upper-tract endourologic stone procedures. J Endourol 18: 971–975. Kuntz, R., Ahyai, S., Lehrich, K. and Fayad, A. (2004) Transurethral holmium laser enucleation of the prostate versus transurethral electrocautery resection of the prostate: a randomized prospective trial in 200 patients. J Urol 172: 1012–1016. Kuntz, R. and Lehrich, K. (2002) Transurethral holmium laser enucleation versus transvesical open enucleation for prostate adenoma greater than 100 gm.: a randomized prospective trial of 120 patients. J Urol 168: 1465–1469. Kuntz, R., Lehrich, K. and Ahyai, S. (2004) Transurethral holmium laser enucleation of the prostate compared with transvesical open prostatectomy: 18-month follow-up of a randomized trial. J Endourol 18: 189–191. Kuntz, R., Lehrich, K. and Ahyai, S. (2008) Holmium laser enucleation of the prostate versus open prostatectomy for prostates greater than 100 grams: 5-year follow-up results of a randomised clinical trial. Eur Urol 53: 160–166. Lourenco, T., Armstrong, N., N’Dow, J. Nabi, G., Deverill, M., Pickard, R. et al. (2008) Systematic review and economic modelling of effectiveness and cost utility of surgical treatments for men with benign prostatic enlargement. Health Technol Assess 12: iii, ix-x, 1-146, 169–515. Madersbacher, S., Lackerner, J., Brossner, C., Rohlich, M., Stancik, I., Wilinger, M. et al. (2005) Prostate Study Group of the Austrian Society of Urology. Reoperation, myocardial infarction and mortality after transurethral and open prostatectomy: A nation-wide, long-term analysis of 23, 123 cases. Eur Urol 47: 499–504. Madersbacher, S. and Marberger, M. (1999) Is transurethral resection of the prostate still justified? BJU Int 83: 227–237. Malek, R., Kang, H., Peng, Y., Stinson, D., Beck, M. and Koullick, E. (2011) Photoselective vaporization
72 http://tau.sagepub.com
Downloaded from tau.sagepub.com at University of Otago Library on March 14, 2015
M Cynk prostatectomy: experience with a novel 180 W 532 nm lithium triborate laser and fiber delivery system in living dogs. J Urol 185: 712–718. Mebust, W., Holtgrewe, H., Cockett, A. and Peters, P. (2002) Transurethral prostatectomy: Immediate and postoperative complications. A cooperative study of 13 participating institutions evaluating 3,885 patients (reprinted from J Urol, vol 141, pg 243–247, 1989). J Urol 167: 999-1003. Montorsi, F., Naspro, R., Salonia, A. Suardi, N., Briganti, A., Zanoni, M. et al. (2004) 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 172: 1926–1929. Moody, J. and Lingeman, J. (2001) Holmium laser enucleation for prostate adenoma greater than 100 gm.: comparison to open prostatectomy. J Urol 165: 459–462. Naspro, R., Suardi, N., Salonia, A. Scattoni, V., Guazzoni, G., Colombo, R. et al. (2006) Holmium laser enucleation of the prostate versus open prostatectomy for prostates >70 g: 24-month follow-up. Eur Urol 50: 563–568. Neill, M., Gilling, P., Kennett, K. Frampton, C., Westenberg, A., Fraundorfer, M. et al. (2006) Randomized trial comparing holmium laser enucleation of prostate with plasmakinetic enucleation of prostate for treatment of benign prostatic hyperplasia. Urology 68: 1020–1024.
Shah, H., Hegde, S., Shah, J., Mahajan, A. and Bansal, M. (2007) Simultaneous transurethral cystolithotripsy with holmium laser enucleation of the prostate: a prospective feasibility study and review of literature. BJU Int 99: 595–600. Shah, H., Shah, H., Shah, R. Shah, R., Hegde, S., Hegde, S., et al. (2006) Sequential holmium laser enucleation of the prostate and laparoscopic extraperitoneal bladder diverticulectomy: initial experience and review of literature. J Endourol 20: 346–350. Shah, H., Sodha, H., Kharodawala, S., Khandkar, A., Hegde, S. and Bansal, M. (2008) Influence of prostate size on the outcome of holmium laser enucleation of the prostate. BJU Int 101: 1536–1541. Suardi, N., Scattoni, V., Briganti, A. Salonia, A., Naspro, R., Gallina, A. et al. (2008) Nerve-sparing radical retropubic prostatectomy in patients previously submitted to holmium laser enucleation of the prostate for bladder outlet obstruction due to benign prostatic enlargement. Eur Urol 53: 1180–1185. Tan, A., Gilling, P., Kennett, K., Frampton, C., Westenberg, A. and Fraundorfer, M. (2003) A randomized trial comparing holmium laser enucleation of the prostate with transurethral resection of the prostate for the treatment of bladder outlet obstruction secondary to benign prostatic hyperplasia in large glands (40 to 200 grams). J Urol 170: 1270–1274.
Peterson, M., Matlaga, B., Kim, S., Kuo, R., Soergel, T., Watkins, S. et al. (2005) Holmium laser enucleation of the prostate for men with urinary retention. J Urol 174: 998–1001; discussion 1001.
Wilson, LC., Gilling, PJ., Williams, A., Kennett, KM., Frampton, CM., Westenberg, AM., et al. (2006) A randomised trial comparing holmium laser enucleation versus transurethral resection in the treatment of prostates larger than 40 grams: results at 2 years Eur Urol 50: 569–73.
Pickard, R., Emberton, M. and Neal, D. (1998) The management of men with acute urinary retention. Br J Urol 81: 712–720.
Wosnitzer, M. and Rutman, M. (2009) KTP/LBO laser vaporization of the prostate. Urol Clin North Am 36: 471–483.
Rassweiler, J., Teber, D., Kuntz, R. and Hofmann, R. (2006) Complications of transurethral resection of the prostate (TURP) – incidence, management, and prevention. Eur Urol 50: 969–979.
Yu, X., Elliott, S., Wilt, T. and McBean, A. (2008) Practice patterns in benign prostatic hyperplasia surgical therapy: The dramatic increase in minimally invasive technologies. J Urol 180: 241–245.
Salonia, A., Suardi, N., Naspro, R. Mazzoccoli, B., Zanni, G., Gallina, A. et al. (2006) Holmium laser enucleation versus open prostatectomy for benign prostatic hyperplasia: an inpatient cost analysis. Urology 68: 302-306.
Zhang, F., Shao, Q., Herrmann, T., Tian, Y. and Zhang, Y. (2012) Thulium laser versus holmium laser transurethral enucleation of the prostate: 18-month follow-up data of a single center. Urology 79: 869–874.
Seki, N., Mochida, O., Kinukawa, N., Sagiyama, K. and Naito, S. (2003) Holmium laser enucleation for prostatic adenoma: analysis of learning curve over the course of 70 consecutive cases. J Urol 170: 1847–1850.
Zhao, Z., Zeng, G., Zhong, W., Mai, Z., Zeng, S. and Tao, X. (2010) A prospective, randomised trial comparing plasmakinetic enucleation to standard transurethral resection of the prostate for symptomatic benign prostatic hyperplasia: three-year follow-up results. Eur Urol 58: 752–758.
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TAU0010.1177/1756287213511509Therapeutic Advances in UrologyM Cynk
Therapeutic Advances in Urology
Review
Holmium laser enucleation of the prostate: a review of the clinical trial evidence
Ther Adv Urol 2014, Vol. 6(2) 62–73 DOI: 10.1177/ 1756287213511509 © The Author(s), 2013. Reprints and permissions: http://www.sagepub.co.uk/ journalsPermissions.nav
Mark Cynk
Abstract: Transurethral resection of the prostate (TURP) has remained the procedure of choice for the surgical treatment of bladder outflow obstruction for almost five decades, but holmium laser enucleation of the prostate (HoLEP) is now emerging as a challenger as the gold standard procedure. This review summarizes the evidence base for HoLEP, with particular reference to randomized, controlled (level 1) evidence.
Keywords: prostatic hyperplasia, laser therapy, treatment outcome, humans, holmium, male, review
Transurethral resection of the prostate (TURP) has remained the procedure of choice for the surgical treatment of bladder outflow obstruction secondary to benign prostatic enlargement (BPE) for almost five decades [Madersbacher and Marberger, 1999]. However, morbidity after TURP is significant, with reported rates of blood transfusion of approximately 8% [AUA Practice Guidelines Committee, 2003], hyponatraemia in up to 3% [Rassweiler et al. 2006], and a reoperation rate of 1% per year [Madersbacher Prostate Study Group, 2005]. Numerous operations have been developed to improve the outcomes and reduce the morbidity of transurethral prostatic surgery, but most have not stood the test of time, either due to patient dissatisfaction or lack of durability [Gilling et al. 1996]. For a procedure to rival and surpass TURP, it needs to be acceptable both to surgeons and patients. It must have a low complication rate and a low reoperation rate. It should be effective in relieving bladder outflow obstruction and ideally it should be cheap [Chandhoke, 1998]. The holmium laser is a pulsed solid state laser, with a wavelength of 2140 nm. This wavelength is strongly absorbed by water, making it ideal for safe use in an aqueous environment. The tissue effects depend on the energy of the laser beam and its interaction with tissue. For holmium laser enucleation of the prostate (HoLEP), 80–100 W of power are used, and delivered to the prostate using an end-firing bare laser fibre. The effect is
precise tissue cutting, with penetration of energy approximately 0.2 mm into prostatic tissue, simultaneous coagulation of blood vessels, and very little thermal spread. HoLEP was originally developed in Tauranga, New Zealand by Peter Gilling and Mark Fraundorfer [Gilling et al. 1996]. The first prostate procedures performed using the holmium laser were ablation procedures, but the surgeons found the technique unacceptably slow. By replacing a side-firing fibre with an end-firing fibre, the surgeons discovered that it was possible to cut away chips of prostate, so the procedure of holmium laser resection of the prostate evolved. Better still, a whole lobe of prostate could be enucleated along the anatomical plane between the adenoma and the prostatic capsule, similar to the principles used in open Millin’s or transvesical prostatectomy. For this development, a morcellator was required to allow efficient and safe removal of the enucleated prostate from within the bladder [Fraundorfer and Gilling, 1998].
Correspondence to: Mark Cynk, MB BS MSc FRCS(Urol) Consultant, Urological Surgeon, Maidstone and Tunbridge Wells NHS Trust, Maidstone Hospital, Hermitage Lane, Maidstone ME16 9QQ, UK [email protected]
This review aims to evaluate the evidence base for HoLEP, with particular reference to randomized, controlled (level 1A) evidence. Comparison with transurethral resection of the prostate There have been five randomized controlled trials comparing HoLEP with conventional TURP (Table 1). The original trial, performed
62 http://tau.sagepub.com
Downloaded from tau.sagepub.com at University of Otago Library on March 14, 2015
M Cynk Table 1. Randomized controlled trials of holmium laser encleation of the prostate (HoLEP) versus transurethral resection of the prostate (TURP).
Tan et al. [2003] Kuntz et al. [2004] Montorsi et al. [2004] Gupta et al. [2006] Eltabey et al. [2010]
HoLEP TURP HoLEP TURP HoLEP TURP HoLEP TURP HoLEP TURP
Patients (n)
Mean operation time (minutes)
Prostate removed (g)
Length of catheter use (days)
Qmax % change
PVR % change
IPSS % change
31 30 100 100 52 48 50 50 40 40
62.1 33.1* 94.6 73.8* 74.0 57.0* 75.4 62.6* 72.8 73.6
40.0* 24.7 32.6 37.2 36.1* 25.4 17.2 24.2* 44.2 37.4
0.7* 1.9 1.0* 2.0 1.3* 2.4 1.2* 2.0 1.5* 2.1
159 122 469 369 206 217 387 427 196 214
70 59 98* 88
83 79 92* 82 81 82 78 76 90* 85
82 76 95* 77
International Prostate Symptom Score, IPSS; PVR, postvoid residual; Qmax, maximum flow rate. *Significant difference P 60 g) prostate gland: plasmakinetic superpulse (bipolar) versus conventional (monopolar) transurethral resection of the prostate. J Endourol 23: 141–145. Chandoke, PS. and DeAntoni, E. (1998) Costeffectiveness analysis: Application to endourology. J Endourology 12: 485–491. Chen, Y., Chen, Q., Wang, Z. Peng, YB., Ma, LM., Zheng, DC. et al. (2013) A prospective, randomized clinical trial comparing plasmakinetic resection of the prostate with holmium laser enucleation of the prostate based on a 2-year followup. J Urol 189: 217–222. Herrmann, TRW., Liatsikos, EN., Nagele, U., Traxer, O., Merseburger, AS. (2012) EAU Guidelines Panel on Laser Technologies. EAU Guidelines on laser Technologies Eur Urol 61: 784–795. El-Hakim, A. and Elhilali, M. (2002) Holmium laser enucleation of the prostate can be taught: the first learning experience. BJU Int 90: 863–869.
http://tau.sagepub.com 71
Downloaded from tau.sagepub.com at University of Otago Library on March 14, 2015
Therapeutic Advances in Urology 6(2) Elmansy, H., Baazeem, A., Kotb, A. Badawy, H., Riad, E., Emran, A. et al. (2012) Holmium laser enucleation versus photoselective vaporization for prostatic adenoma greater than 60 ml: preliminary results of a prospective, randomized clinical trial. J Urol 188: 216–221. Eltabey, M., Sherif, H. and Hussein, A. (2010) Holmium laser enucleation versus transurethral resection of the prostate. Can J Urol 17: 5447-5452. Elzayat, E., Habib, E. and Elhilali, M. (2005) Holmium laser enucleation of the prostate: a size-independent new ‘gold standard’. Urology 66(5 Suppl.): 108–113. Fayad, A., Sheikh, M., Zakaria, T., Elfottoh, H. and Alsergany, R. (2011) Holmium laser enucleation versus bipolar resection of the prostate: a prospective randomized study. Which to choose? J Endourol 25: 1347–1352. Fraundorfer, M. and Gilling, P. (1998) Holmium:YAG laser enucleation of the prostate combined with mechanical morcellation: preliminary results. Eur Urol 33: 69–72. Fraundorfer MR., Gilling PJ., Kennett KM., Dunton NG. (2001) Holmium laser resection of the prostate is more cost effective than transurethral resection of the prostate: Results of a randomized prospective study. Urology 57: 454–458. Gilling, P., Aho, T., Frampton, C., King, C. and Fraundorfer, M. (2008) Holmium laser enucleation of the prostate: results at 6 years. Eur Urol 53: 744–749. Gilling, P., Cass, C., Cresswell, M., Malcolm, A. and Fraundorfer, M. (1996) The use of the holmium laser in the treatment of benign prostatic hyperplasia. J Endourol 10: 459–461. Gilling, P., Wilson, L., King, C., Westenberg, A., Frampton, C. and Fraundorfer, M. (2012) Long-term results of a randomized trial comparing holmium laser enucleation of the prostate and transurethral resection of the prostate: results at 7 years. BJU Int 109: 408–411. Gong, Y., He, D., Wang, M. Li, X., Zhu, G., Zheng, Z. et al. (2012) Holmium laser enucleation of the prostate: a modified enucleation technique and initial results. J Urol 187: 1336–1340. Gupta, N., Sivaramakrishna, Kumar, R., Dogra, P. and Seth, A. (2006) Comparison of standard transurethral resection, transurethral vapour resection and holmium laser enucleation of the prostate for managing benign prostatic hyperplasia of > 40 g. BJU Int 97: 85–89. Hochreiter, W., Thalmann, G., Burkhard, F. and Studer, U. (2002) Holmium laser enucleation of the prostate combined with electrocautery resection: the mushroom technique. J Urol 168: 1470–1474.
Humphreys, M., Miller, N., Handa, S., Terry, C., Munch, L. and Lingeman, J. (2008) Holmium laser enucleation of the prostate - outcomes independent of prostate size? J Urol 180: 2431-2435; discussion 2435. Hwang, J., Park, S. and Lee, J. (2010) Holmium laser enucleation of the prostate for benign prostatic hyperplasia: effectiveness, safety, and overcoming of the learning curve. Korean J Urol 51: 619–624. Kastner, C., Beard, R., Woodhams, S., Knight, O. and Popert, R. (2010) A journey of skills – theory and practice of a multi-modal approach to holmium laser prostatectomy. Br J Med Surg Urol 3: 160–166. Kim, S., Tinmouth, W., Kuo, R., Paterson, R. and Lingeman, J. (2004) Simultaneous holmium laser enucleation of prostate and upper-tract endourologic stone procedures. J Endourol 18: 971–975. Kuntz, R., Ahyai, S., Lehrich, K. and Fayad, A. (2004) Transurethral holmium laser enucleation of the prostate versus transurethral electrocautery resection of the prostate: a randomized prospective trial in 200 patients. J Urol 172: 1012–1016. Kuntz, R. and Lehrich, K. (2002) Transurethral holmium laser enucleation versus transvesical open enucleation for prostate adenoma greater than 100 gm.: a randomized prospective trial of 120 patients. J Urol 168: 1465–1469. Kuntz, R., Lehrich, K. and Ahyai, S. (2004) Transurethral holmium laser enucleation of the prostate compared with transvesical open prostatectomy: 18-month follow-up of a randomized trial. J Endourol 18: 189–191. Kuntz, R., Lehrich, K. and Ahyai, S. (2008) Holmium laser enucleation of the prostate versus open prostatectomy for prostates greater than 100 grams: 5-year follow-up results of a randomised clinical trial. Eur Urol 53: 160–166. Lourenco, T., Armstrong, N., N’Dow, J. Nabi, G., Deverill, M., Pickard, R. et al. (2008) Systematic review and economic modelling of effectiveness and cost utility of surgical treatments for men with benign prostatic enlargement. Health Technol Assess 12: iii, ix-x, 1-146, 169–515. Madersbacher, S., Lackerner, J., Brossner, C., Rohlich, M., Stancik, I., Wilinger, M. et al. (2005) Prostate Study Group of the Austrian Society of Urology. Reoperation, myocardial infarction and mortality after transurethral and open prostatectomy: A nation-wide, long-term analysis of 23, 123 cases. Eur Urol 47: 499–504. Madersbacher, S. and Marberger, M. (1999) Is transurethral resection of the prostate still justified? BJU Int 83: 227–237. Malek, R., Kang, H., Peng, Y., Stinson, D., Beck, M. and Koullick, E. (2011) Photoselective vaporization
72 http://tau.sagepub.com
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M Cynk prostatectomy: experience with a novel 180 W 532 nm lithium triborate laser and fiber delivery system in living dogs. J Urol 185: 712–718. Mebust, W., Holtgrewe, H., Cockett, A. and Peters, P. (2002) Transurethral prostatectomy: Immediate and postoperative complications. A cooperative study of 13 participating institutions evaluating 3,885 patients (reprinted from J Urol, vol 141, pg 243–247, 1989). J Urol 167: 999-1003. Montorsi, F., Naspro, R., Salonia, A. Suardi, N., Briganti, A., Zanoni, M. et al. (2004) 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 172: 1926–1929. Moody, J. and Lingeman, J. (2001) Holmium laser enucleation for prostate adenoma greater than 100 gm.: comparison to open prostatectomy. J Urol 165: 459–462. Naspro, R., Suardi, N., Salonia, A. Scattoni, V., Guazzoni, G., Colombo, R. et al. (2006) Holmium laser enucleation of the prostate versus open prostatectomy for prostates >70 g: 24-month follow-up. Eur Urol 50: 563–568. Neill, M., Gilling, P., Kennett, K. Frampton, C., Westenberg, A., Fraundorfer, M. et al. (2006) Randomized trial comparing holmium laser enucleation of prostate with plasmakinetic enucleation of prostate for treatment of benign prostatic hyperplasia. Urology 68: 1020–1024.
Shah, H., Hegde, S., Shah, J., Mahajan, A. and Bansal, M. (2007) Simultaneous transurethral cystolithotripsy with holmium laser enucleation of the prostate: a prospective feasibility study and review of literature. BJU Int 99: 595–600. Shah, H., Shah, H., Shah, R. Shah, R., Hegde, S., Hegde, S., et al. (2006) Sequential holmium laser enucleation of the prostate and laparoscopic extraperitoneal bladder diverticulectomy: initial experience and review of literature. J Endourol 20: 346–350. Shah, H., Sodha, H., Kharodawala, S., Khandkar, A., Hegde, S. and Bansal, M. (2008) Influence of prostate size on the outcome of holmium laser enucleation of the prostate. BJU Int 101: 1536–1541. Suardi, N., Scattoni, V., Briganti, A. Salonia, A., Naspro, R., Gallina, A. et al. (2008) Nerve-sparing radical retropubic prostatectomy in patients previously submitted to holmium laser enucleation of the prostate for bladder outlet obstruction due to benign prostatic enlargement. Eur Urol 53: 1180–1185. Tan, A., Gilling, P., Kennett, K., Frampton, C., Westenberg, A. and Fraundorfer, M. (2003) A randomized trial comparing holmium laser enucleation of the prostate with transurethral resection of the prostate for the treatment of bladder outlet obstruction secondary to benign prostatic hyperplasia in large glands (40 to 200 grams). J Urol 170: 1270–1274.
Peterson, M., Matlaga, B., Kim, S., Kuo, R., Soergel, T., Watkins, S. et al. (2005) Holmium laser enucleation of the prostate for men with urinary retention. J Urol 174: 998–1001; discussion 1001.
Wilson, LC., Gilling, PJ., Williams, A., Kennett, KM., Frampton, CM., Westenberg, AM., et al. (2006) A randomised trial comparing holmium laser enucleation versus transurethral resection in the treatment of prostates larger than 40 grams: results at 2 years Eur Urol 50: 569–73.
Pickard, R., Emberton, M. and Neal, D. (1998) The management of men with acute urinary retention. Br J Urol 81: 712–720.
Wosnitzer, M. and Rutman, M. (2009) KTP/LBO laser vaporization of the prostate. Urol Clin North Am 36: 471–483.
Rassweiler, J., Teber, D., Kuntz, R. and Hofmann, R. (2006) Complications of transurethral resection of the prostate (TURP) – incidence, management, and prevention. Eur Urol 50: 969–979.
Yu, X., Elliott, S., Wilt, T. and McBean, A. (2008) Practice patterns in benign prostatic hyperplasia surgical therapy: The dramatic increase in minimally invasive technologies. J Urol 180: 241–245.
Salonia, A., Suardi, N., Naspro, R. Mazzoccoli, B., Zanni, G., Gallina, A. et al. (2006) Holmium laser enucleation versus open prostatectomy for benign prostatic hyperplasia: an inpatient cost analysis. Urology 68: 302-306.
Zhang, F., Shao, Q., Herrmann, T., Tian, Y. and Zhang, Y. (2012) Thulium laser versus holmium laser transurethral enucleation of the prostate: 18-month follow-up data of a single center. Urology 79: 869–874.
Seki, N., Mochida, O., Kinukawa, N., Sagiyama, K. and Naito, S. (2003) Holmium laser enucleation for prostatic adenoma: analysis of learning curve over the course of 70 consecutive cases. J Urol 170: 1847–1850.
Zhao, Z., Zeng, G., Zhong, W., Mai, Z., Zeng, S. and Tao, X. (2010) A prospective, randomised trial comparing plasmakinetic enucleation to standard transurethral resection of the prostate for symptomatic benign prostatic hyperplasia: three-year follow-up results. Eur Urol 58: 752–758.
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