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Original Research

Evaluation of efficacy and safety of simultaneous bipolar transurethral prostate resection and holmium: YAG laser cystolithotripsy


1 Sağlık Bakanlığı, Numune Eğitim ve Araştırma Hastanesi, Üroloji Kliniği, Adana, Türkiye

2 Sağlık Bakanlığı, Haseki Eğitim ve Araştırma Hastanesi, Üroloji Kliniği, İstanbul, Türkiye


DOI :
New J Urol. 2014; 9 (3): 52-57

Abstract

Objective: We aimed to evaluate the efficacy and safety of Holmium: YAG Laser Cystolithot-ripsy (HLS) procedures performed for bladder stones (>20 mm) in the same session with bipolar transurethral prostate resection (Plasmakinetic Transurethral Prostate Resection (PK-TURP)).

Material and Methods: Files of thirty-three patients underwent HLS for large bladder stones (>20 mm) and PK-TURP for Benign Prostatic Obstruction (BPO) in the same session in our clinic between January 2012 and July 2013 were analyzed retrospectively. Patient demographics, IPSS, Qmax, PVR, prostate volume, stone size, operative time, perioperative complications, length of hospital stay, were evaluated.

Results: The mean patient age was 67,54±10,52 (45-84) years. The mean stone size, preoperative prostate volume, fragmentation du-ration, all operation duration and length of hospi-tal stay were 31,39±8,91 (20-60) mm, 65,45±12,7 (45-94) cc, 40,48±13,6 (20-90) minutes, 109,39±19,75 (65-150) minutes and 3,56±1,14 (2-7) days, respectively. No major intraoperative complications occurred. After a mean follow-up of 6 months, no recurrent stones were recorded. No patients required blood transfusions nor de-veloped blood clot retentions. The most common complication after surgery was transient stress urinary incontinence in two patients. One pa-tient needed another surgical intervention for a residual stone post operatively. Three patients developed urinary tract infection and bulbar urethral strictures developed in four patients after six months post operatively. Three of them also had intraoperative bladder mucosal injury. Complications were graded using modified Clavien grading system. Post operative third month life quality was found to be sta-tistically better than preoperative quality of life (p<0,05).

Conclusions: We believe that with a very high efficacy, low morbidity and safety, HLS procedures may be performed for blad-der stones (>20 mm) in the same session with PK-TURP for BPO.

Key Words: Bladder Stone, Prostate, Laser


Abstract

Objective: We aimed to evaluate the efficacy and safety of Holmium: YAG Laser Cystolithot-ripsy (HLS) procedures performed for bladder stones (>20 mm) in the same session with bipolar transurethral prostate resection (Plasmakinetic Transurethral Prostate Resection (PK-TURP)).

Material and Methods: Files of thirty-three patients underwent HLS for large bladder stones (>20 mm) and PK-TURP for Benign Prostatic Obstruction (BPO) in the same session in our clinic between January 2012 and July 2013 were analyzed retrospectively. Patient demographics, IPSS, Qmax, PVR, prostate volume, stone size, operative time, perioperative complications, length of hospital stay, were evaluated.

Results: The mean patient age was 67,54±10,52 (45-84) years. The mean stone size, preoperative prostate volume, fragmentation du-ration, all operation duration and length of hospi-tal stay were 31,39±8,91 (20-60) mm, 65,45±12,7 (45-94) cc, 40,48±13,6 (20-90) minutes, 109,39±19,75 (65-150) minutes and 3,56±1,14 (2-7) days, respectively. No major intraoperative complications occurred. After a mean follow-up of 6 months, no recurrent stones were recorded. No patients required blood transfusions nor de-veloped blood clot retentions. The most common complication after surgery was transient stress urinary incontinence in two patients. One pa-tient needed another surgical intervention for a residual stone post operatively. Three patients developed urinary tract infection and bulbar urethral strictures developed in four patients after six months post operatively. Three of them also had intraoperative bladder mucosal injury. Complications were graded using modified Clavien grading system. Post operative third month life quality was found to be sta-tistically better than preoperative quality of life (p<0,05).

Conclusions: We believe that with a very high efficacy, low morbidity and safety, HLS procedures may be performed for blad-der stones (>20 mm) in the same session with PK-TURP for BPO.

Key Words: Bladder Stone, Prostate, Laser

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