Enucleación prostática con láser de holmio (HoLEP) mediante cirugía sin ingreso: una alternativa posible y segura / Holmium laser enucleation of the prostate (HoLEP) as same-day surgery: A safe and feasible option

Objetivo Estudiar la viabilidad de la enucleación prostática con láser de holmio (HoLEP) en circuito de cirugía mayor ambulatoria. Material y métodos Se realiza un estudio prospectivo observacional en el que se incluyen 25 pacientes intervenidos de HoLEP que han sido dados de alta el mismo día de la cirugía según criterios previamente establecidos. Resultados La edad media de los pacientes intervenidos fue de 65,1 años. El volumen prostático medio fue de 45,8cc. Todos los pacientes fueron dados de alta el día de la cirugía (alta efectiva 100%). El porcentaje de complicaciones en nuestra serie fue del 12%, todas ellas grado I según la Clasificación Clavien Dindo. Ningún paciente precisó reingreso en los 30 días posteriores al procedimiento. El porcentaje de satisfacción con el circuito de cirugía ambulatoria fue del 95%. Conclusiones Tras el análisis inicial de nuestros datos podemos concluir que el HoLEP ambulatorio es una técnica eficaz y segura con bajo riesgo de complicaciones. El circuito de cirugía ambulatoria es el preferido por los pacientes intervenidos de HoLEP (AU)

Objective To study the feasibility of holmium laser enucleation (HoLEP) performed as a same-day surgery. Material and methods Prospective observational study including 25 patients submitted to HoLEP. Patients were discharged the same day if they met the established criteria. Results The mean age of the patients was 65.1 years and prostate volume was 45.8cc. All patients were discharged the same day of surgery. The overall complication rate at 30 days was 12% (Clavien I 100%). The rate of re-hospitalization was 0%. Patient satisfaction rate with the day surgery pathway was 95%. Conclusions The initial analysis of our results suggests that outpatient HoLEP is a safe and effective alternative with low rate of complications. According to satisfaction rates, patients prefer the day surgery pathway for the performance of HoLEP (AU)

Holmium laser enucleation of the prostate (HoLEP) as same-day surgery: A safe and feasible option.

OBJECTIVE: To study the feasibility of holmium laser enucleation (HoLEP) performed as a same-day surgery. MATERIAL AND METHODS: Prospective observational study including 25 patients submitted to HoLEP. Patients were discharged the same day if they met the established criteria. RESULTS: The mean age of the patients was 65.1 years and prostate volume was 45.8cc. All patients were discharged the same day of surgery. The overall complication rate at 30 days was 12% (Clavien I 100%). The rate of re-hospitalization was 0%. Patient satisfaction rate with the day surgery pathway was 95%. CONCLUSIONS: The initial analysis of our results suggests that outpatient HoLEP is a safe and effective alternative with low rate of complications. According to satisfaction rates, patients prefer the day surgery pathway for the performance of HoLEP.

Laparoscopic adenomectomy: 10 years of experience. / Adenomectomía laparoscópica: 10 años de experiencia.

INTRODUCTION: Lower urinary tract symptoms secondary to increased prostate volume are associated with ageing and are becoming more prevalent due to increased life expectancy. We present our experience with transperitoneal laparoscopic adenomectomy for the management of bladder outlet obstruction caused by benign prostatic enlargement. MATERIALS AND METHODS: We performed a retrospective review of patients who underwent laparoscopic adenomectomy between 2005 and 2015. We recorded age, maximum flow and postvoid residual urine (preoperative and postoperative), surgical time, operative bleeding, weight and pathology, complications and duration of catheterisation and hospitalisation. RESULTS: We included 80 patients with a mean age of 70 years. The mean preoperative and postoperative Qmax was 8.21mL/s and 22.52mL/s, respectively. The mean preoperative and postoperative postvoid residual urine was 91.4mL and 14.2mL, respectively. The mean surgical time was 137.7min. Conversion to open surgery was necessary in one case due to intestinal injury. The mean intraoperative bleeding was 227.6mL. The mean hospital stay was 5.46 days, and the catheterisation time was 4.86 days. There were 13 complications, which were recorded according to the Clavien-Dindo system, 3 of which were severe. The mean weight of the surgical specimen was 80.02g. Pathology showed benign hyperplasia in 75 cases and prostate cancer in the remaining 5. CONCLUSION: Laparoscopic adenomectomy is a safe, reproducible technique with the same functional results as open surgery. Our series shows that this approach is useful and safe and has a low rate of complications.