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PURPOSE: To investigate factors associated with early recovery of stress urinary incontinence (SUI) following holmium laser enucleation of the prostate (HoLEP) in patients with benign prostatic enlargement (BPE). METHODS: The medical records of 393 patients who underwent HoLEP for BPE were retrospectively reviewed. Patients with SUI following HoLEP were selected and divided into 2 groups: those who experienced early recovery of SUI and those who experienced persistent SUI. Recovery of SUI within 1 month after HoLEP was defined as early, and SUI that remained present after 1 month was defined as persistent. Preoperative clinical and urodynamic factors, as well as perioperative factors, were compared between groups. RESULTS: SUI following HoLEP was detected in 86 patients. Thirty-three patients exhibited recovery of SUI within 1 month, and SUI remained present in 53 patients after 1 month. Multivariate analysis showed that the transition zone prostate volume (odds ratio [OR], 5.354; 95% confidence interval [CI], 1.911–14.999; P=0.001) and the enucleation ratio (OR, 8.253; 95% CI, 1.786–38.126; P=0.007) were significantly associated with early recovery of SUI. CONCLUSIONS: Early recovery of SUI within 1 month following HoLEP was associated with transition zone prostate volume and the enucleation ratio.
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Humans , Holmium , Lasers, Solid-State , Medical Records , Multivariate Analysis , Prostate , Prostatic Hyperplasia , Retrospective Studies , Urinary Incontinence , UrodynamicsABSTRACT
Objective To study the efficacy of transurethral holmium laser resection as well as instant intravesical Pirarubicin instillation for superficial bladder carcinoma.Methods 51 cases with superficial bladder cancer were divided into observation group(A) including 26 cases and control group(B) including 25 cases stochastically.The 26 cases of group A were received transurethral holmium laser resection as well as instant intravesical Pirarubicin instillation therapy whereas 25 cases of group B received transurethral resection therapy.All patients of both groups were treated with intravesical instillation of Pirarubicin therapy regularly at least 1 year and have been followed up for 15 to 39 months.Results Differences were not significant between the two groups in the mean operation time and bladder perforation rate(P ＞0.05 ),but indwelling period of urethral catheter was markedly decreased in group A than group B ( P ＜ 0.05 ).There were 4 cases of recurrence in group A,recurrence rate was 15.4％ (4/26).While there were 11 cases of recurrence in group B,recurrence rate was 44.0％ (11/25 ).Significant difference in cancer recurrence rate was found between two groups ( P ＜ 0.05 ).Conclusion Compared with transurethral resection therapy transurethral holmium laser resection as well as instant intravesical Pirarubicin instillation for superficial bladder carcinoma was more effective and quicker recovery,which has a good applied future in the clinical practice.
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Objective: To summarize and compare the clinical therapeutic effect of holmium laser resection (HoLR) and transurethral resection (TUR) on superficial bladder tumors. Methods: Twenty-six bladder cancer patients received HoLR therapy and 38 cases received TUR therapy. The mean operative time, the case number with bladder perforation, the number of patients receiving postoperative bladder perfusion, indwelling time of urethral catheter, incidence of urethral meatal stenosis, and postoperative recurrence were analyzed and compared between the two groups. Results: The patients were followed up for 6-28 months. The difference was not significant between the two groups in the mean operative time, indwelling period of urethral catheter, incidence of urethral meatal stenosis and postoperative recurrence (P >0.05). But the number of patients who need postoperative bladder perfusion was markedly decreased in HoLRBt group than TURBt group (P <0.05). Conclusion: The HoLRBt therapy has definite effects on bladder tumors and causes less serious complications. Compared with TURBt, HoLRBt has more advantages in reducing the incidence of bladder perforation.
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Objective To evaluate the outcomes of meniscal injures treated by Ho∶YAG laser using arthroscopy.MethodsA total of 31 patients with meniscal injury were treated with holmium∶YAG laser by arthroscopy from January 2006 to March 2008 in our hospital.Among the cases,11 had flap tear,8 had horizontal tear,6 showed bucket-handle tear,and 6 were found with longitudinal tear.The pre-and post-operative Lysholm score,and compilations in the patients were recorded.Results The operation was completed successfully in all the cases with a mean operation time of 44 min(rang,22-55 min).No injuries to the vessels and nerves occurred in the surgery.The patients got out of bed in 1 to 4 days after the surgery(mean,2.1 days).All the surgical wounds achieved primary healing.Follow-up was carried out in the patients for 9 to 28 months(mean,14.5 months).The patients showed significantly lower Lysholm score at 6 months during the follow-up than that determined before the operation(92?6 vs 57?13,t=13.61,P=0.00).Among the cases,21 showed excellent outcomes,7 were good,and 3 were improved.The rate of excellent and good results was 90.3%(28/31).Conclusion Ho∶YAG laser is a safe,simple,and effective tool in cutting menisci under a arthroscope.
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Objective To evaluate the clinical effect of Ho:YAG laser lithotripsy in management of ureteral calculi and to investigate its influential factors. Methods The data of 137 cases of ureteral calculi (66 males and 71 females;aged 19-71 years with a mean of [(45.0?10.4)years;disease course from 4 days to 10 years with a mean of (1.50?0.65)years] treated via ureteroscope with Ho:YAG laser lithotripsy were analyzed retrospectively.Of them 112 cases had 1 stone,and 25 had more than one.Fifty five cases had stones on the left side,71,on the right side;11,on both sides;107 cases had stones in the lower ureter and 30,in the middle or upper ureter.The size of the stones were 0.6-2.0 cm in diameter with a mean of ( 1.1? 0.3) cm.Of them 23 cases had ureteral polyp and they underwent Ho:YAG laser vaporization resection of the polyp;11 cases had ureteral stricture and they underwent ureter dilatation or Ho:YAG laser incision of the stricture and lithotripsy.Double J tube was placed after operation. Results The overall stone fragmentation rate was 94.9%(130/137) with a single procedure.Stone free time was 5-56 d with a mean of ( 21.5 ?13.4) d.Operating time was (20-120)min with a mean of (60.4?18.3)min.Post operative hospital stay was 1～10 d with a mean of (2.4?1.1)d.In the successful operation group (130/137),the mean stone size was (1.03?0.24)cm in diameter, while in the failure group it was (1.47?0.51) cm. Four cases of the failure group had ureteral stricture;2 of them underwent shift to open operation, the other 2 experienced failure because of difficulty of placing D J tube. Three cases also experienced failure because of stone shift in the operation;of them 1 underwent shift to open operation,the other 2 were treated by ESWL.The differences of the stone size,concomitant ureteral stricture, stone shift in operation between success group and failure group were statistically significant ( P