Mp13-13 wolf 24f vs. storz 28f laser scope for holmium laser enucleation of the prostate (holep): interim analysis of a prospective rct

You have accessJournal of UrologyCME1 Apr 2023MP13-13 WOLF 24F VS. STORZ 28F LASER SCOPE FOR HOLMIUM LASER ENUCLEATION OF THE PROSTATE (HOLEP): INTERIM ANALYSIS OF A PROSPECTIVE RCT Nick Dean, Matthew Lee, Mark Assmus, Jenny Guo, Jessica Helon, and Amy Krambeck Nick DeanNick Dean More articles by this author , Matthew LeeMatthew Lee More articles by this author , Mark AssmusMark Assmus More articles by this author , Jenny GuoJenny Guo More articles by this author , Jessica HelonJessica Helon More articles by this author , and Amy KrambeckAmy Krambeck More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003233.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Holmium laser enucleation of the prostate (HoLEP) is routinely performed with a 24, 26, or a 28 French (F) laser scope. Proponents of the 28F scope state that larger sheath size allows for superior flow and visibility leading to a more efficient operation and better hemostasis. Those utilizing the 24F scope suggest the smaller size is less traumatic, resulting in a lower incidence of urethral strictures and temporary incontinence. We sought to compare outcomes of HoLEP using the 24F and 28F laser scope. METHODS: From May 2022 to October 2022, we prospectively randomized 59 patients with prostates 200 cm3 or less undergoing HoLEP 1:1 to either a 24F or 28F laser scope. IRB approval (STU00215646) and registry with ClinicalTrials.gov (NCT05308017) was obtained. The primary outcome was differences in surgical duration between groups (mins). Secondary outcomes included surgeon scope evaluation (flow rate, visualization, and intra-operative complications) and post-operative patient outcomes. RESULTS: There was no difference in demographics and prostate features between patients randomized to 28F (n=30) versus 24F (n=29) (p>0.05). Intra-operative variables including procedure, enucleation, and morcellation time (s), as well as OR specimen weight (g), and enucleation efficiency (g/min) were not different between groups (all p>0.05). The 28F scope was associated with improved surgeon-graded flow and visualization (p<0.01); however, there was no difference in intra-operative complications (p=0.48). Successful same day catheter removal occurred in 48/54 (89%) patients with no statistical difference between groups (24F 81% versus 28F 96% p=0.09). Time to complete continence was statistically shorter in the 24F group (5.8 versus 15.2 days, p=0.04). Time to resolution of hematuria (5.0 versus 6.4 days, p=0.33) and dysuria (4.8 versus 4.0 days, p=0.65) was not different between groups. There were no differences in presence of hematuria, incontinence, and dysuria between groups at one and three-month patient surveys. There were no major complications (CD>3b), urethral strictures, or bladder neck contractures in either group during the follow-up period. CONCLUSIONS: The 28F laser scope was associated with improved surgeon gradings. There were no statistically significant differences in intra-operative or post-operative outcomes at 1 and 3-month follow up due to scope size; however, in the immediate postoperative period the 24F scope may lead to earlier return of continence. Source of Funding: Richard Wolf © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e178 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nick Dean More articles by this author Matthew Lee More articles by this author Mark Assmus More articles by this author Jenny Guo More articles by this author Jessica Helon More articles by this author Amy Krambeck More articles by this author Expand All Advertisement PDF downloadLoading ...