Investig Clin Urol.  2017 May;58(3):200-204. 10.4111/icu.2017.58.3.200.

Measuring change in prostate size after holmium laser enucleation: A prospective study

• Oh JK
• Ko KP
• Oh SJ

• KMID: 2388065
• DOI: http://doi.org/10.4111/icu.2017.58.3.200

Abstract

PURPOSE
To analyze postoperative outcomes of prostate surgery, resected specimen weight is commonly used. The difference between the preoperative calculated transitional zone volume and actual enucleated specimen weight following holmium laser enucleation of the prostate (HoLEP) is reported at over 20%. The reason for this difference is unclear. We assessed the association of volume of the prostatic adenoma with enucleated weight, the volume and calculated volume of the adenoma by pre- and postoperative ultrasonographic measurement.
MATERIALS AND METHODS
All patients were prospectively enrolled who underwent HoLEP by two surgeons (SJO and JKO) between 2010 and 2015. Preoperative and postoperative prostate ultrasonography examinations were performed by a single examiner (JKO) during surgery, and weight and volume of the enucleated adenoma were measured. We compared preoperative adenoma size with postoperative weight and volume of the enucleated adenoma, calculated enucleated volume using ultrasonography, and calculated the correlation coefficients between preoperative adenoma volume and postoperative parameters.
RESULTS
One hundred forty-two patients with a mean age (±standard deviation) of 69.8 (±8.8) years were analyzed. The mean preoperative ultrasound-measured adenoma volume was 31.7 (±21.4) mL, while postoperatively the mean retrieved weight of the adenoma was 22.3 (±17.0) g and the mean volume was 22.3 (±16.8) mL. Postoperatively calculated enucleated volume using ultrasonography was most strongly correlated with preoperative adenoma size (Pearson correlation coefficient 0.965, p<0.01).
CONCLUSIONS
Our study showed a significant difference between preoperative adenoma size and postoperative enucleated weight of adenoma during HoLEP. Postoperatively calculated enucleated volume using ultrasonography may be the most reliable parameter to assess surgical outcomes following HoLEP.

Keyword

Holmium; Lasers; Prostate; Ultrasonography

MeSH Terms

Adenoma
Holmium*
Humans
Lasers, Solid-State*
Prospective Studies*
Prostate*
Prostatic Hyperplasia
Surgeons
Ultrasonography
Holmium

Figure

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  Fig. 1 An example of postoperatively ultrasonographic assessment using ellipsoid method. (A) Postoperative prostate volume. (B) Defect volume.

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