HOLMIUM-YAG LASER ENUCLEATION OF THE PROSTATE COMBINED WITH MECHANICAL MORCELLATION - PRELIMINARY-RESULTS

Objectives: To determine the feasibility of holmium laser enucleation of the prostate (HoLEP) combined with mechanical morcellation to surgi cally treat bladder outflow obstruction due to the larger prostate. Me thods: The first 14 patients treated with this new combination techniq ue are described. Standard preoperative investigations were performed and all patients were assessed at 1 month postoperatively with an AUA symptom score and peak urinary flow rate (Q(max),,,). Both transurethr al (8 patients) and suprapubic (6 patients) morcellation was utilised. Results: The mean ultrasound volume of the prostate was 98.6 mi (55-2 00). The mean total operating room time was 98 min (64-190). No patien t required blood transfusion but 2 patients required postoperative bla dder irrigation. Twelve of the patients were discharged catheter-free the following day. The only significant complication was extraperitone al extravasation from the suprapubic site in 2 patients. At 1 month th e mean Q(max),, was 25.2 ml/s and the mean AUA score was 7.2. Conclusi ons: This combination of techniques offers a minimally morbid method o f treating the larger prostate gland.