A prospective trial of laser fiber degradation following holmiumlaser enucleation of the prostate utilizing moses bph technology vs regular mode

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology I (MP01)1 Sep 2021MP01-16 A PROSPECTIVE TRIAL OF LASER FIBER DEGRADATION FOLLOWING HOLMIUM LASER ENUCLEATION OF THE PROSTATE UTILIZING MOSES BPH TECHNOLOGY VS REGULAR MODE Mark Assmus, Matthew Lee, Sivaguru Mayandi, Deepak Agarwal, Tim Large, Bruce Fouke, and Amy Krambeck Mark AssmusMark Assmus More articles by this author , Matthew LeeMatthew Lee More articles by this author , Sivaguru MayandiSivaguru Mayandi More articles by this author , Deepak AgarwalDeepak Agarwal More articles by this author , Tim LargeTim Large More articles by this author , Bruce FoukeBruce Fouke More articles by this author , and Amy KrambeckAmy Krambeck More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001962.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To compare perioperative and post-operative outcomes for holmium laser enucleation of the prostate (HoLEP) between cases performed with a 550um standard laser fiber versus a 550um MOSES 2.0 fiber in BPH mode, with primary outcome of fiber degradation. METHODS: We prospectively collected outcomes for 50 consecutive HoLEP cases using a 550um MOSES fiber with MOSES 2.0 BPH mode. All patients were treated at 2J and 40Hz for enucleation and 1J and 20Hz for coagulation. Outcomes were compared to our historical cohort of 50 patients using 550um standard fibers on standard mode. The length of exposed fiber was measured at the start and end of each case with the difference being our primary outcome of degradation length. Additionally, five consecutive 550um standard fibers and five 550um MOSES fibers and their respective controls underwent high resolution 3-D microCT postoperatively. Four 2D Line profile (4-pixel width average) analyses were performed for each fiber at its area of maximum damage. Peak to trough ratios based on 8-bit relative intensity versus distance in pixels for each line profile were performed. Control fibers were assigned a peak to trough ratio of 1.0. Mann-Whitney U, 2-tailed T-tests and Chi-squared tests were used, significance set to p <0.05. RESULTS: The 550um standard fibers demonstrated greater degradation than the 550um MOSES fibers with 2.0 BPH mode (2.9cm (IQR 1.7-4.3cm) vs 0.2cm (IQR 0.1-0.4cm), p <0.01). This difference remained significant when comparing degradation per energy used, per minute enucleation and per gram enucleated (all p <0.05). None of the 50 cases with MOSES fiber and 2.0 BPH mode required intraoperative interruption to re-strip the fiber. Pertinent post-operative outcomes were similar between cohorts (dysuria, median hemoglobin decrease, AUASS, Qmax, QOL score. All p >0.05). Objective laser fiber degradation by 2D line profile analysis showed more damage to standard fibers (average peak to trough ratio for MOSES compared to standard was, 1.35±0.37 versus 1.82±0.80 respectively, p=0.026). CONCLUSIONS: Use of the 550um MOSES fiber with MOSES 2.0 BPH mode resulted in significantly less fiber degradation when compared to a standard 550um laser with standard mode. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e7-e7 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mark Assmus More articles by this author Matthew Lee More articles by this author Sivaguru Mayandi More articles by this author Deepak Agarwal More articles by this author Tim Large More articles by this author Bruce Fouke More articles by this author Amy Krambeck More articles by this author Expand All Advertisement PDF downloadLoading ...