None listed
Conditions
Brief summary
It is well known, that Holmium Laser Enucleation of Prostate (HoLEP) is laser treatment for benign prostatic hyperplasia (BPH) with many advantages in comparison with transurethral resection of prostate (TURP) and open prostatectomy. Despite this, the shallow learning curve has hindered its wide adoption among urologists. Many studies have previously assessed the learning curve of this difficult endourological procedure, both in a retrospective, as well as in a prospective manner. Different outcome measures were used in these studies, showing varying case-loads to reach a plateau. In general, a number approximating 50 cases is the consensus of the literature regarding the learning curve of this operation. However, only one study assessed the surgeon’s stress during this operation and this was done using a simply way, a stress score calculated with a Visual Analogue Scale (VAS). The aim of this study is to assess and quantify the learning experience of a single surgeon following the Holmium User Group (HUG) HoLEP mentorship programme (HUG-MP), during the initial learning curve of holmium laser enucleation of the prostate (HoLEP). Primary outcomes will be the surgical efficiency and surgeon’s stress levels during the operation. Surgical efficiency will be measured with enucleation efficiency (weight of enucleated tissue divided by lasing time) and laser to prostate ratio (L/P ratio; amount of consumed laser energy divided by retrieved prostate tissue weight). Stress during HoLEP will be assessed by measuring heart rate of the surgeon with an armband heart rate monitor and by the surgeon himself, using a self-evaluation questionnaire immediately after the procedure, the state-trait anxiety inventory for adults (STAI Form Y-1).
Interventions
Holmium Laser Enucleation of Prostate (HoLEP).
This operation involves a transurethral enucleation of the prostatic adenoma, with the use of Holmium Laser. This is the first part of the procedure, when the tissue is enucleated and then during the second part, the enucleated tissue with the use of a morcellator is removed.
The length of operation (HOLEP) depends on surgical experience and prostate size ranging from 30min to 180 min.
TURP (transurethral resection of the prostate) is the classic
Holmium Laser Enucleation of Prostate (HoLEP). This operation involves a transurethral enucleation of the prostatic adenoma, with the use of Holmium Laser. This is the first part of the procedure, when the tissue is enucleated and then during the second part, the enucleated tissue with the use of a morcellator is removed. The length of operation (HOLEP) depends on surgical experience and prostate size ranging from 30min to 180 min. TURP (transurethral resection of the prostate) is the classic method for the management of benign prostatic enlargement. During the initial learning curve of HoLEP, if a surgeon finds very difficult to complete the enucleation due to different reasons, eg lack o view, inability to find and maintain the plane between adenoma and prostatic capsule, he can converts to TURP in order to avoid significant complications.. In TURP, with the respectoscope, chips of prostate are removed to create a good cavity in prostatic urethra and treat the bladder outflow obstruction.
Sponsors
Spyridon Kampantais
Study design
Allocation
Non-randomised trial
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
Male
Age
40 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients that will undergo HoLEP for Bladder Outlet Obstruction (BOO) symptoms, acute or chronic retention of Urine. Male. Age higher or equal of 40 years old. Preoperative prostate volume < 120cc.
Exclusion criteria
Patients that will undergo only median lobe enucleation Previous prostatic operation excluding BNI (bladder neck incision)
Outcome results
None listed