EAU 2018: One-Lobe Enucleation HoLEP Could Be Safely Performed Especially for Large Prostate
First, Dr. Terada presented his methods for a one-lobe HoLEP. He begins with the incision of the urethral membrane at 6 o’clock position, followed by dissection of adenoma out of the surgical capsule at the 12 o’clock position. The bilateral distal edge of urethral membrane is then incised to allow laser enucleation of the adenoma from the 6 to 12 o’clock position. An incision of the bladder neck membrane is performed at the 12 to 6 o’clock position to free the adenoma further. Finally, the bilaterally resected planes are connected at the 6 o’clock position and the adenoma is pushed into the bladder.
For his comparison, a correlation plot between prostate volume and surgical time of a one-lobe and two-lobe procedure was provided. The plot indicated that the surgical time for a one-lobe procedure was less independent on prostate volume than in a two-lobe procedure. Additionally, the surgical time for the one-lobe procedure was also found to be significantly shorter than that of a two-lobe procedure, especially in large prostates.
In conclusion, the one-lobe procedure can be performed more safely and in less surgical time than two-lobe procedure eluding that the enucleation of one-lobe is an efficacious treatment modality, especially in large prostates.
Speaker: Dr. N. Terada
Written by: Whitney Zhang, Department of Urology, University of California-Irvine at the 2018 European Association of Urology Meeting EAU18, 16-20 March, 2018 Copenhagen, Denmark