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- Title
Perioperative Outcomes of Holmium Laser Enucleation of the Prostate: A Systematic Review.
- Authors
Porreca, Angelo; Colicchia, Michele; Tafuri, Alessandro; D'Agostino, Daniele; Busetto, Gian Maria; Crestani, Alessandro; Odorizzi, Katia; Amigoni, Nelia; Rizzetto, Riccardo; Gozzo, Alessandra; Gallina, Sebastian; Bianchi, Lorenzo; Ferro, Matteo; Falabella, Roberto; Romagnoli, Daniele; Antonelli, Alessandro; Corsi, Paolo; Schiavina, Riccardo
- Abstract
Introduction: The aim of the study was to systematically review the literature and describe perioperative complications of holmium laser enucleation of the prostate (HoLEP), including the Clavien-Dindo classification of surgical complications. Methods: All English language publications on HoLEP were evaluated. We followed the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) guidelines to evaluate PubMed®, Scopus®, and Web of Science™ databases from January 1, 1998, to June 1, 2020. Results: Fifty-seven studies were included, for a total of 10,371 procedures. We distinguished between intra-, peri-, and postoperative complications. Overall, the rate of complications is 0–7%. Intraoperative complications include incomplete morcellation (2.3%), capsular perforation (2.2%), bladder (2.4%), and ureteric orifice (0.4%) injuries. Perioperative complications include postoperative urinary retention (0.2%), hematuria and clot retention (2.6%), and cystoscopy for clot evacuation (0.7%). Postoperative complications include dysuria (7.5%), stress (4.0%), urge (1.8%), transient (7%) and permanent (1.3%) urinary incontinence, urethral stricture (2%) and bladder neck contracture (1%). Conclusions: HoLEP is a safe procedure, with a satisfactory low complication rate. The most common reported perioperative complications are not severe (Clavien-Dindo classification grades 1–2). Further randomized studies are certainly warranted to fully determine the predictor of surgical complications in order to prevent them and improve this technique.
- Subjects
SURGICAL enucleation; HOLMIUM; BLADDER obstruction; PROSTATE; SURGICAL complications; URETEROSCOPY; CYSTOSCOPY
- Publication
Urologia Internationalis, 2022, Vol 106, Issue 10, p979
- ISSN
0042-1138
- Publication type
Article
- DOI
10.1159/000518560