Complications and Proposed Preventive Measure of Holumium Laser Enucleation of the Prostate during the Initial Phase at Our Hospital

Clinical charts of 95 patients who underwent holmium laser enucleation of the prostate (HoLEP) between May 2012 and January 2016 were reviewed for complications and their causative factors, as well as treatment outcomes. Of 23 intraoperative complications and 3 cases of prolonged post prostatectomy...

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Veröffentlicht in:Hinyokika kiyo. Acta urologica Japonica. - 1962. - 64(2018), 5 vom: 31. Mai, Seite 207-212
1. Verfasser: Takeuchi, Yasuharu (VerfasserIn)
Weitere Verfasser: Sekido, Noritoshi, Sawada, Yoshitomo, Hashimoto, Hironori, Miyazaki, Kouichi, Watanabe, Kuroudo, Watanabe, Shoutaro, Kinno, Kurenai, Niitsu, Yasuo, Endo, Fumiyasu
Format: Online-Aufsatz
Sprache:Japanese
Veröffentlicht: 2018
Zugriff auf das übergeordnete Werk:Hinyokika kiyo. Acta urologica Japonica
Schlagworte:Journal Article Holmium W1XX32SQN1
Beschreibung
Zusammenfassung:Clinical charts of 95 patients who underwent holmium laser enucleation of the prostate (HoLEP) between May 2012 and January 2016 were reviewed for complications and their causative factors, as well as treatment outcomes. Of 23 intraoperative complications and 3 cases of prolonged post prostatectomy incontinence, 23 incidents (89%) occurred within the initial 20 cases performed by each surgeon. The details of the intraoperative complications were : bladder injury, 6 (6.3%) ; perforation at 6 o'clock beneath the bladder neck, 2 (2.1%) ; capsular perforation, 4 (4.2%) ; and equipment failure, 9 (9.5%). Bladder injury and capsular perforation resulted frompoor hemostasis, while perforation beneath the bladder neck resulted fromforceful retrograde dissection under disorientation. Excessive tension in the external sphincter during retrograde dissection, but not antegrade, could lead to prolonged incontinence. HoLEP improved bladder outlet obstruction subjectively and objectively. During the initial phase of HoLEP, adequate hemostasis and meticulous plane dissection at the bladder neck and antegrade dissection at the apical portions are of paramount importance to prevent significant surgical complications
Beschreibung:Date Completed 27.03.2019
Date Revised 27.03.2019
published: Print
Citation Status MEDLINE
ISSN:0018-1994
DOI:10.14989/ActaUrolJap_64_5_207