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- Title
Simultaneous Holmium Laser Enucleation of Prostate and Upper-Tract Endourologic Stone Procedures.
- Authors
Samuel C. Kim; William W. Tinmouth; Ramsay L. Kuo; Ryan F. Paterson; James E. Lingeman
- Abstract
Background and Purpose: The holmium laser is a versatile urologic tool. Its unique cutting and coagulatingproperties allow multiple procedures, such as stone fragmentation and laser enucleation of the prostate(HoLEP), to be performed with a single set-up. This paper reviews our experience with simultaneous HoLEPand endourologic upper-tract stone procedures.Patients and Methods: We retrospectively reviewed all 11 patients (12 renal units) treated with the combinedapproach of HoLEP and an upper-tract endourologic procedure for stone disease. All patients initiallyunderwent HoLEP, followed immediately by percutaneous nephrolithotomy (PCNL)(N = 2), ureteroscopy(URS)(N = 8), or both (N = 1). The mean stone diameter was 34.7 mm for PCNL and 6.7 mm for URS. Outcomedata and complications were recorded.Results: The mean preoperative and postoperative American Urological Association Symptom Scores were21.8 and 6.3, respectively. The mean prostatic specimen weight was 118 g (range 21–376 g), and the mean hospitalstay was 1.4 days. For 10 patients with available prostatic specific antigen (PSA) data, the mean preoperativeand postoperative values were 6.2 and 0.9 ng/mL, respectively. All patients were catheter free at discharge.All three PCNL patients were rendered stone free; all four URS patients who had radiographicfollow-up were stone free. There were no short- or long-term complications, and no transfusions were necessary.Conclusions: Simultaneous HoLEP and laser lithotripsy are feasible, emphasizing the unique capabilitiesof the holmium laser. The hemostasis offered by HoLEP allows safe removal of prostatic tissue and urinarycalculi, obviating multiple procedures.
- Publication
Journal of Endourology, 2004, Vol 18, Issue 10, p971
- ISSN
0892-7790
- Publication type
Article
- DOI
10.1089/end.2004.18.971