Langzeitergebnisse nach endoskopischer Enukleation der Prostata View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-11

AUTHORS

T. R. W. Herrmann

ABSTRACT

BACKGROUND: In the last 20 years various transurethral endoscopic enucleation techniques (EEP) have been established as a substitute for open prostatectomy (OP) and TURP. Since the 2016 update of the "EAU Guidelines on Management of Non-Neurogenic Male Lower Urinary Tract Symptoms (LUTS), including Benign Prostatic Obstruction (BPO)", Holmium laser enucleation of the prostate (HoLEP) and bipolar enucleation being summarized as anatomical enucleating techniques are proposed as first choice for the surgical management of BPO of large volume prostates. OBJECTIVES: The purpose of this review is to demonstrate the available data on long-term outcomes of current EEP techniques. MATERIALS AND METHODS: PubMed/Medline and Scopus were searched using the terms: long term, HoLEP, ThuLEP, ThuVEP, DiLEP, ELEP, GreenlEP, Greenlight enucleation, bipolar enucleation, plasmakinetic enucleation, monopolar enucleation, and transurethral enucleation. Studies with a follow-up ≥48 months were selected. RESULTS: In all, 5 randomized controlled trials (2 HoLEP, 2 bipolar enucleation, 1 Thulium laser resection of the prostate in tangerine technique [TmLR-TT]), 3 prospective cohort studies (2 thulium vapoenucleation [ThuVEP], 1 TmLRP-TT), and 2 retrospective studies with large patient cohorts were selected. All EEP were equivalent to OP with regard to effectivity and durability of results. The rate of secondary surgical procedures in HolEP, ThuVEP, bipolar enucleation and tangerine technique (TmLRP-TT) was 0-1.2 % for reTURP, 1.9-3.75 % for urethrotomy, and 0.9-4 % for bladder neck resection. No significant difference in the individual studies was found when compared to OP. For bipolar enucleation vs. TURP long-term results for uroflow, residual urine, and IPSS were significantly better at 60 months for bipolar enucleation. One RCT TmLRP-TT vs. TURP at the 48-month follow-up found no significant difference. CONCLUSION: Various transurethral EEP can be considered as equally safe and effective anatomical enucleation techniques. All displayed EEPs match the durability of OP. The choice of energy source for EEP seems to be secondary and a function of resources and personal preference of the skilled surgeon. More... »

PAGES

1446-1454

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00120-016-0245-8

DOI

http://dx.doi.org/10.1007/s00120-016-0245-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1039986876

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/27714414


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