Related Experiment Video
Updated: Aug 14, 2025
Photoselective Vaporesection of the Prostate via an End-firing Lithium Triborate Crystal Laser
Published on: May 9, 2018
Observation of complications assessed by Clavien-Dindo classification in different endoscopic procedures of benign
Ting-Ting Pan1, Sheng-Qun Li, Ya Dai
1Department of Urology, The First People's Hospital of Linping District, Hangzhou City, Zhejiang Province, China.
Insights
The Clavien-Dindo classification (CDC) offers detailed surgical complication insights. Holmium laser enucleation of the prostate (HoLEP) shows superior outcomes and fewer complications compared to transurethral resection of the prostate (TURP) and plasmakinetic resection of the prostate (PKRP) for benign prostatic hyperplasia (BPH).
Area of Science:
- Urology
- Surgical Oncology
- Medical Technology
Background:
- The Clavien-Dindo classification (CDC) is standard for surgical complications but has limitations in urological literature.
- Variations in reporting complications for benign prostatic hyperplasia (BPH) treatments exist.
Purpose of the Study:
- To compare surgical complications of transurethral resection of the prostate (TURP), plasmakinetic resection of the prostate (PKRP), and holmium laser enucleation of the prostate (HoLEP) using a detailed Clavien-Dindo classification framework.
- To evaluate the efficacy and safety of these BPH surgical techniques.
Main Methods:
- A retrospective study of 623 patients undergoing TURP, PKRP, or HoLEP between January 2018 and December 2020.
- Complications were systematically assessed and compared among the three surgical groups using the Clavien-Dindo classification.
- Key perioperative and postoperative outcomes were analyzed.
Main Results:
- Holmium laser enucleation of the prostate (HoLEP) and plasmakinetic resection of the prostate (PKRP) demonstrated significantly shorter operation times, reduced irrigation volumes, and shorter hospital stays compared to transurethral resection of the prostate (TURP).
- HoLEP showed significantly fewer complications, including electrolyte disturbances, urinary tract irritation, and lower Clavien-Dindo grades, compared to both TURP and PKRP.
- HoLEP also exhibited lower rates of lower abdominal pain, intraoperative and secondary hemorrhage, and clot retention than TURP.
Conclusions:
- The Clavien-Dindo classification provides enhanced insight into surgical complications, aiding comparative analysis.
- Holmium laser enucleation of the prostate (HoLEP) is recommended as a preferred surgical option for benign prostatic hyperplasia (BPH) due to its favorable surgical characteristics and significantly lower complication rates.
Abstract:
The Clavien-Dindo classification (CDC) was widely used in the assessment of surgical complications, but some inconsistencies always existed in urological literature. This study was aimed to report complications of the transurethral resection of the prostate (TURP), plasmakinetic resection of the prostate (PKRP), and holmium laser enucleation of the prostate (HoLEP) by using a more detailed way under the framework of CDC. A total of 623 eligible cases underwent endoscopic procedures from January 2018 and December 2020 were divided into the TURP group (212 cases), the PKRP group (208 cases), and the HoLEP group (203 cases) according to the surgical type. Patients' surgical complications assessed by the CDC were compared among the 3 groups. The operation time, intraoperative irrigation volume, postoperative irrigation time and volume, decrease in hemoglobin and sodium, postoperative catheterization time, visual analogue scale, hospital stay of the PKEP group and the HoLEP group were significantly less than those of the TURP group, and the decrease in hemoglobin and visual analogue scale in the HoLEP group were significantly lower than those in the PKEP group (all P < .05). The electrolyte disturbance, urinary tract irritation, and patients with grade II of CDC in the PKRP group were significantly lower than those in the TURP group; The electrolyte disturbance, lower abdominal pain, urinary tract irritation, intraoperative hemorrhage, secondary hemorrhage, clot retention, patients with grade I, II, III of CDC in the HoLEP group were significantly lower than those in the TURP group, and the urinary tract irritation, grade I, II of CDC in the HoLEP group was significantly lower than that in the PKRP group (all P < .05). The CDC should be recommended because of the enhanced insight into surgical complications, and the HoLEP should be given a priority for Benign prostatic hyperplasia (BPH) surgical treatment in terms of the merits in surgical characteristics and complications.
Related Concept Videos
01:26Endoscopic Procedures V: ERCP
Patient...
01:29Endoscopic Procedures I: Esophagogastroduodenoscopy
During an EGD, the endoscope can be used to:
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:25Urinary Tract Calculi VI: Surgical Management