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Published in: World Journal of Urology 4/2015

01-04-2015 | Invited Review

HoLEP has come of age

Authors: Michael W. Vincent, Peter J. Gilling

Published in: World Journal of Urology | Issue 4/2015

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Abstract

Introduction

Lower urinary tract symptoms (LUTS) are a common complaint and although can be adequately managed with medication, surgery remains the mainstay of treatment. Transurethral resection has been the reference ‘gold standard’, but due to its complications and issues with larger volume prostates, many alternatives have been developed and assessed. Holmium laser enucleation of the prostate (HoLEP) has shown excellent efficacy, durability and safety and has become an important alternative that has gained guideline approval.

Results

HoLEP has been shown to have outcomes that are equivalent or better than TURP in both urodynamic measurements and symptom scores. Its outcomes have been proven to be durable and cost-effective. HoLEP has fewer and less serious complications when compared to the current reference standard, its use also allows earlier removal of catheter and hospital discharge. Appropriate mentoring reduces many of the issues associated with the steep learning curve, thus removing the main hurdle to its widespread adoption as the surgical treatment of choice for LUTS due to benign prostatic hyperplasia (BPH).

Conclusions

HoLEP fulfils all of the requirements as an alternative/replacement for TURP and open prostatectomy, with equivalent outcomes and reduced complications. With improvements in the learning curve, it could now be considered the true gold standard surgical treatment for BPH. HoLEP has come of age.
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Metadata
Title
HoLEP has come of age
Authors
Michael W. Vincent
Peter J. Gilling
Publication date
01-04-2015
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 4/2015
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-014-1443-x

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