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Published in: Current Urology Reports 5/2023

17-02-2023 | Urinary Incontinence | BENIGN PROSTATIC HYPERPLASIA (J SILBERSTEIN AND C BENSON, SECTION EDITORS)

Comparison of Contemporary Surgical Outcomes Between Holmium Laser Enucleation of the Prostate and Robotic-Assisted Simple Prostatectomy

Authors: T. Max Shelton, Connor Drake, Ruben Vasquez, Marcelino Rivera

Published in: Current Urology Reports | Issue 5/2023

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Abstract

Purpose of Review

This study reviews contemporary literature on RASP and HoLEP to evaluate perioperative outcomes, common complications, cost analytics, and future directions of both procedures.

Recent Findings

RASP is indicated for prostates > 80 mL, while HoLEP is size-independent. No notable differences were found in operative time, PSA nadir (surrogate for enucleation volume), re-catheterization rates, or long-term durability. Prolonged incontinence and bladder neck contracture rates are low for both surgeries. Patients experience similar satisfaction outcomes and improvements in uroflowmetry and post-void residual volumes. HoLEP demonstrates shorter hospitalizations, lower transfusion rates, lower costs, and higher rates of same-day discharge. RASP offers a shorter learning curve and lower rates of early postoperative urinary incontinence.

Summary

HoLEP is a size-independent surgery that offers advantages for patients seeking a minimally invasive procedure with the potential for catheter-free same-day discharge. Future directions with single-port simple prostatectomy may offer parity in same-day discharge, but further research is needed to determine broader feasibility.
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Metadata
Title
Comparison of Contemporary Surgical Outcomes Between Holmium Laser Enucleation of the Prostate and Robotic-Assisted Simple Prostatectomy
Authors
T. Max Shelton
Connor Drake
Ruben Vasquez
Marcelino Rivera
Publication date
17-02-2023
Publisher
Springer US
Published in
Current Urology Reports / Issue 5/2023
Print ISSN: 1527-2737
Electronic ISSN: 1534-6285
DOI
https://doi.org/10.1007/s11934-023-01146-9

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