Efficacy, efficiency, and safety of en-bloc vs. three-lobe enucleation of the prostate: a propensity score-matched analysis

Alexander Tamalunas; Melanie Schott; Patrick Keller; Michael Atzler; Benedikt Ebner; Martin Hennenberg; Christian G. Stief; Giuseppe Magistro

doi:10.1117/12.3000707

12 March 2024 Efficacy, efficiency, and safety of en-bloc vs. three-lobe enucleation of the prostate: a propensity score-matched analysis

Alexander Tamalunas, Melanie Schott, Patrick Keller, Michael Atzler, Benedikt Ebner, Martin Hennenberg, Christian G. Stief, Giuseppe Magistro

Author Affiliations +

Proceedings Volume 12817, Advanced Photonics in Urology 2024; 128170A (2024) https://doi.org/10.1117/12.3000707
Event: SPIE BiOS, 2024, San Francisco, California, United States

Abstract

To assess efficacy, efficiency, and safety in holmium laser enucleation of the prostate (HoLEP), we directly compared intraoperative performance, postoperative outcomes, and safety in the original three-lobe enucleation technique with the more recent en-bloc method. Retrospective, propensity score-matched analysis of 606 men who underwent HoLEP for LUTS/BPO. Patients were stratified by technique, and groups were compared for perioperative parameters, safety, and short-term functional outcomes. While postoperative symptoms and urodynamic parameters improved irrespective of technique, we report significantly less adverse events (Clavien-Dindo classification >/=II vs < II) for patients receiving en-bloc enucleation. Additionally, en-bloc enucleation was more efficient i.e., less than half of total laser energy (kJ), twice shorter enucleation time, and surgical performance (g/kJ/min) significantly increased 4-fold with prostate volume, compared to three-lobe enucleation. While HoLEP in general is a safe and effective procedure, en-bloc enucleation techniques offer better surgical performance.

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(2024) Published by SPIE. Downloading of the abstract is permitted for personal use only.

Citation Download Citation

Alexander Tamalunas, Melanie Schott, Patrick Keller, Michael Atzler, Benedikt Ebner, Martin Hennenberg, Christian G. Stief, and Giuseppe Magistro "Efficacy, efficiency, and safety of en-bloc vs. three-lobe enucleation of the prostate: a propensity score-matched analysis", Proc. SPIE 12817, Advanced Photonics in Urology 2024, 128170A (12 March 2024); https://doi.org/10.1117/12.3000707

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