TY - JOUR T1 - Clinical Outcomes and Efficacy of Enbloc Holmium Laser Enucleation of the Prostate (HoLEP): A Retrospective Analysis of 60 Patients TT - Prostatın Enbloc Holmium Lazer Enükleasyonunun (HoLEP) Klinik Sonuçları ve Etkinliği: 60 Hastanın Retrospektif Analizi AU - Sobay, Resul AU - Güngör, Hasan Samet AU - İnkaya, Abdurrahman AU - Beyatlı, Murat AU - Tahra, Ahmet AU - Küçük, Eyüp Veli PY - 2025 DA - September Y2 - 2025 DO - 10.47482/acmr.1721801 JF - Archives of Current Medical Research JO - Arch Curr Med Res PB - 14 Mart Tıbbiyeliler Derneği WT - DergiPark SN - 2717-9788 SP - 243 EP - 251 VL - 6 IS - 3 LA - en AB - Background: Benign prostatic hyperplasia (BPH) affects a significant proportion of aging men, causing lower urinary tract symptoms and decreased quality of life. Holmium Laser Enucleation of the Prostate (HoLEP) has emerged as a minimally invasive surgical treatment, with the enbloc technique representing a refinement of the procedure.Methods: We retrospectively analyzed data from 60 patients who underwent Enbloc HoLEP at our institution. Patient characteristics, perioperative parameters, and clinical outcomes including American Urological Association Symptom Scores (AUASS), Quality of Life (QoL) scores, post-void residual volumes (PVR), and complication rates were assessed.Results: Mean patient age was 65.5 ± 9.1 years with mean prostate volume of 98.3 ± 34.7 cc. Following Enbloc HoLEP, AUASS significantly decreased from 23.3 ± 6.0 to 6.1 ± 2.0 (p KW - Benign prostatic hyperplasia KW - Holmium laser enucleation of prostate KW - Enbloc technique KW - Lower urinary tract symptoms KW - Minimally invasive surgery N2 - Arka plan: Benign prostat hiperplazisi (BPH) yaşlanan erkeklerin önemli bir bölümünü etkileyerek alt üriner sistem semptomlarına ve yaşam kalitesinde azalmaya neden olmaktadır. Prostatın Holmiyum Lazer Enükleasyonu (HoLEP) minimal invaziv bir cerrahi tedavi olarak ortaya çıkmıştır ve enblok teknik prosedürün geliştirilmiş halini temsil etmektedir.Yöntemler: Kurumumuzda Enblok HoLEP uygulanan 60 hastanın verilerini retrospektif olarak analiz ettik. Hasta özellikleri, perioperatif parametreler ve American Urological Association Symptom Scores (AUASS), Quality of Life (QoL) skorları, post-void rezidüel volüm (PVR) ve komplikasyon oranları dahil klinik sonuçlar değerlendirildi.Bulgular Ortalama hasta yaşı 65.5 ± 9.1 yıl ve ortalama prostat hacmi 98.3 ± 34.7 cc idi. Enblok HoLEP sonrası AUASS anlamlı olarak 23.3 ± 6.0'dan 6.1 ± 2.0'a (p CR - McVary KT, Roehrborn CG, Avins AL, et al. American Urological Association guideline: management of benign prostatic hyperplasia (BPH). 2010; revised 2021. CR - Foo KT. Pathophysiology of clinical benign prostatic hyperplasia. Asian J Urol. 2017;4(3):152-157. CR - Reich O, Gratzke C, Bachmann A, et al. Morbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10,654 patients. J Urol. 2008;180(1):246-249. CR - Gilling PJ, Kennett K, Das AK, Thompson D, Fraundorfer MR. Holmium laser enucleation of the prostate (HoLEP) combined with transurethral tissue morcellation: an update on the early clinical experience. J Endourol. 1998;12(5):457-459. CR - Kuntz RM, Lehrich K, Ahyai SA. Holmium laser enucleation of the prostate versus open prostatectomy for prostates greater than 100 grams: 5-year follow-up results of a randomised clinical trial. Eur Urol. 2008;53(1):160-166. CR - Tan AH, Gilling PJ, Kennett KM, Frampton C, Westenberg AM, Fraundorfer MR. A randomized trial comparing holmium laser enucleation of the prostate with transurethral resection of the prostate for the treatment of bladder outlet obstruction secondary to benign prostatic hyperplasia in large glands (40 to 200 grams). J Urol. 2003;170(4 Pt 1):1270-1274. CR - Scoffone CM, Cracco CM. The en-bloc no-touch holmium laser enucleation of the prostate (HoLEP) technique. World J Urol. 2016;34(8):1175-1181. CR - Minagawa S, Okada S, Morikawa H. Safety and effectiveness of holmium laser enucleation of the prostate using a low-power laser. Urology. 2017;110:51-55. CR - Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002;21(2):167-178. CR - Lerner LB, McVary KT, Barry MJ, et al. Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA GUIDELINE PART II. J Urol. 2021;206(4):818-826. CR - Knuuti J, Wijns W, Saraste A, et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J. 2020;41(3):407-477. CR - Gilling PJ, Wilson LC, King CJ, Westenberg AM, Frampton CM, Fraundorfer MR. Long-term results of a randomized trial comparing holmium laser enucleation of the prostate and transurethral resection of the prostate: results at 7 years. BJU Int. 2012;109(3):408-411. CR - Krambeck AE, Handa SE, Lingeman JE. Experience with more than 1,000 holmium laser prostate enucleations for benign prostatic hyperplasia. J Urol. 2013;189(1 Suppl):S141-145. CR - Elmansy HM, Kotb A, Elhilali MM. Holmium laser enucleation of the prostate: long-term durability of clinical outcomes and complication rates during 10 years of followup. J Urol. 2011;186(5):1972-1976. CR - Kim M, Song SH, Ku JH, Kim HJ, Paick JS. Pilot study of the clinical efficacy of ejaculatory hood sparing technique for ejaculation preservation in Holmium laser enucleation of the prostate. Int J Impot Res. 2015;27(1):20-24. CR - Enikeev D, Glybochko P, Rapoport L, et al. A randomized trial comparing the learning curve of 3 endoscopic enucleation techniques (HoLEP, ThuFLEP, and MEP) for BPH using mentoring approach—initial results. Urology. 2018;121:51-57. CR - Shah HN, Mahajan AP, Hegde SS, Bansal MB. Peri-operative complications of holmium laser enucleation of the prostate: experience in the first 280 patients, and a review of literature. BJU Int. 2007;100(1):94-101. CR - Nam JK, Kim HW, Lee DH, Han JY, Lee JZ, Park SW. Risk Factors for Transient Urinary Incontinence after Holmium Laser Enucleation of the Prostate. World J Mens Health. 2015;33(2):88-94. CR - Elmansy HM, Kotb A, Elhilali MM. Is there a way to predict stress urinary incontinence after holmium laser enucleation of the prostate? J Urol. 2011;186(5):1977-1981. CR - Gong YG, He DL, Wang MZ, et al. Holmium laser enucleation of the prostate: a modified enucleation technique and initial results. J Urol. 2012;187(4):1336-1340. CR - Cornu JN, Ahyai S, Bachmann A, et al. A Systematic Review and Meta-analysis of Functional Outcomes and Complications Following Transurethral Procedures for Lower Urinary Tract Symptoms Resulting from Benign Prostatic Obstruction: An Update. Eur Urol. 2015;67(6):1066-1096. CR - Kampantais S, Dimopoulos P, Tasleem A, Acher P, Gordon K, Young A. Assessing the Learning Curve of Holmium Laser Enucleation of Prostate (HoLEP). A Systematic Review. Urology. 2018;120:9-22. CR - Peyronnet B, Robert G, Comat V, et al. Learning curves and perioperative outcomes after endoscopic enucleation of the prostate: a comparison between GreenLight 532-nm and holmium lasers. World J Urol. 2017;35(6):973-983. CR - Herrmann TR, Bach T, Imkamp F, et al. Thulium laser enucleation of the prostate (ThuLEP): transurethral anatomical prostatectomy with laser support. Introduction of a novel technique for the treatment of benign prostatic obstruction. World J Urol. 2010;28(1):45-51. CR - Shigemura K, Tanaka K, Yamamichi F, Chiba K, Fujisawa M. Comparison of Predictive Factors for Postoperative Incontinence of Holmium Laser Enucleation of the Prostate by the Surgeons’ Experience During Learning Curve. Int Neurourol J. 2016;20(1):59-68. CR - Robert G, Cornu JN, Fourmarier M, et al. Multicentre prospective evaluation of the learning curve of holmium laser enucleation of the prostate (HoLEP). BJU Int. 2016;117(3):495-499. CR - Malde S, Rajagopalan A, Patel N, Simões AS, Narahari K, Arya M. Potassium-titanyl-phosphate laser photoselective vaporization for benign prostatic hyperplasia: 5-year follow-up from a district general hospital. J Endourol. 2012;26(7):878-883. CR - Mamoulakis C, Ubbink DT, de la Rosette JJ. Bipolar versus monopolar transurethral resection of the prostate: a systematic review and meta-analysis of randomized controlled trials. Eur Urol. 2009;56(5):798-809. UR - https://doi.org/10.47482/acmr.1721801 L1 - https://dergipark.org.tr/en/download/article-file/4968615 ER -