Related Experiment Video
Updated: Oct 14, 2025
Surgical Treatment for Benign Prostatic Hyperplasia: Holmium Laser Enucleation of the Prostate HoLEP.
Published on: March 6, 2018
Does MOSES pulse modulation reduce short-term catheter reinsertion following holmium laser enucleation of the
Dane E Klett1, Bryce Baird2, Colleen T Ball3
1Department of Urology, Mayo Clinic Rochester, Rochester, MN, USA.
Purpose:
Previously published studies have shown small prostate size, capsular perforation and intraoperative bladder distension are associated with failed trial without a catheter (TWOC) after HoLEP. The study objective was to determine the relationship between MOSES pulse modulation versus standard laser technology and short-term catheter reinsertion following failed TWOC.
Materials And Methods:
The study included 487 patients who underwent HoLEP, using standard holmium laser settings (180 patients) or MOSES pulse modulation (255 patients), between August 2018 and February 2021. Catheter reinsertion defined as reinsertion following failed TWOC within 30 days of surgery. Association of pulse modulation with catheter reinsertion was examined using single and multivariable logistic regression models. Comparisons of pre and intraoperative characteristics between patients treated without and with pulse modulation were made using a Wilcoxon rank sum test for numeric characteristics or Fisher's exact test for categorical characteristics.
Results:
Short-term catheter reinsertion occurred in 14% (26/180) of the standard laser setting group as compared with 10% (24/252) of the pulse modulation group. There was no statistically significant association with short-term catheter reinsertion in single (unadjusted OR [standard settings vs. pulse modulation], 1.60; 95% CI, 0.80-2.91; p=0.12) or multivariable analysis adjusting for specimen weight and operative time (adjusted OR [standard settings vs. pulse modulation], 1.44; 95% CI, 0.77-2.68; p=0.25).
Conclusions:
In this study, we found no association between post-HoLEP short-term catheter reinsertion following failed TWOC and MOSES pulse modulation. Although MOSES pulse modulation offers several well-documented advantages, catheter reinsertion events appear to be attributable to other factors.
Insights
MOSES pulse modulation did not significantly impact short-term catheter reinsertion after holmium laser enucleation of the prostate (HoLEP). Other factors, not the laser technology, appear to influence catheter reinsertion after failed trial without catheter (TWOC).
Area of Science:
- Urology
- Surgical Technology
- Medical Devices
Background:
- Previous studies link small prostate size, capsular perforation, and intraoperative bladder distension to failed trial without catheter (TWOC) after holmium laser enucleation of the prostate (HoLEP).
- Understanding factors influencing TWOC success is crucial for optimizing patient outcomes and reducing healthcare resource utilization.
Purpose of the Study:
- To investigate the relationship between MOSES pulse modulation and standard laser technology in relation to short-term catheter reinsertion following failed TWOC after HoLEP.
- To determine if advanced laser technology influences the need for catheter reinsertion post-HoLEP.
Main Methods:
- A retrospective study of 487 patients undergoing HoLEP between August 2018 and February 2021.
- Patients were divided into groups receiving standard holmium laser settings (180 patients) or MOSES pulse modulation (255 patients).
- Statistical analysis using logistic regression models examined the association between pulse modulation and catheter reinsertion within 30 days of surgery.
Main Results:
- Short-term catheter reinsertion occurred in 14% of the standard laser group versus 10% of the MOSES pulse modulation group.
- No statistically significant association was found between MOSES pulse modulation and short-term catheter reinsertion in either single or multivariable analysis.
- Adjusted odds ratio for catheter reinsertion with standard settings versus pulse modulation was 1.44 (95% CI, 0.77-2.68; p=0.25).
Conclusions:
- MOSES pulse modulation was not associated with a statistically significant difference in short-term catheter reinsertion after failed TWOC post-HoLEP.
- Factors other than the laser technology itself appear to be the primary drivers of catheter reinsertion events.
- While MOSES pulse modulation offers other benefits, its impact on preventing catheter reinsertion following failed TWOC requires further investigation into alternative contributing factors.
