Prostate shape significantly affects the HoLEP procedure time and energy usage: A retrospective pilot study

Area of Science:

• Urology
• Surgical Technology
• Medical Imaging

Background:

• Benign Prostatic Hyperplasia (BPH) is a common condition requiring surgical intervention.
• Holmium Laser Enucleation of the Prostate (HoLEP) is an effective treatment for BPH.
• Prostate morphology may impact surgical outcomes.

Purpose of the Study:

• To evaluate the influence of prostate dimensions (longitudinal vs. transverse) on HoLEP outcomes.
• To compare surgical efficiency and patient results based on prostate shape.

Main Methods:

• Patients were categorized into two groups based on prostate shape using MRI: longitudinal (longitudinal > transverse diameter) and oval (transverse > longitudinal diameter).
• Pre-operative, peri-operative, and one-month post-operative data, including urinary parameters, were analyzed.
• Surgical metrics such as enucleation time, morcellation time, laser energy usage, and complications were compared between groups.

Main Results:

• Group 1 (longitudinal shape) showed significantly shorter lateral lobe enucleation time (p < 0.01), lower laser energy consumption, and better enucleation efficiency.
• No significant differences were observed in median lobe enucleation time, morcellation time, hemoglobin drop, catheterization duration, or hospital stay.
• Both groups exhibited comparable improvements in urinary parameters and complication rates.

Conclusions:

• Prostate shape, as determined by MRI measurements, is a significant factor influencing HoLEP outcomes.
• Longitudinal prostate morphology is associated with enhanced surgical efficiency during HoLEP.
• Understanding prostate shape can aid in optimizing surgical planning and patient selection for HoLEP.