Lasers in transurethral enucleation of the prostate-do we really need them

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dc.authorid0000-0002-6308-1763
dc.contributor.authorHerrmann, Thomas R. W.
dc.contributor.authorGravas, Stavros
dc.contributor.authorde la Rosette, Jean J. M. C. H.
dc.contributor.authorWolters, Mathias
dc.contributor.authorAnastasiadis, Aristotelis G.
dc.contributor.authorGiannakis, Ioannis
dc.date.accessioned2020-07-09T16:46:49Z
dc.date.available2020-07-09T16:46:49Z
dc.date.issued2020
dc.departmentİstanbul Medipol Üniversitesi, Uluslararası Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Üroloji Ana Bilim Dalı
dc.description.abstractThe acronym EEP, coding for transurethral Endoscopic Enucleation of the Prostate, was introduced in 2016 by the European Association of Urology (EAU) guidelines panel on management of non-neurogenic male lower urinary tract symptoms (LUTS) and benign prostatic obstruction (BPO). Since then, a laser-based treatment, Holmium Laser Enucleation of the Prostate (HoLEP), and the current-based treatment of bipolar enucleation of the prostate (BipoLEP) are equally appreciated as valuable options for the management of benign prostatic obstruction (BPO). This was mainly inspired by the results of two meta-analyses on randomized controlled trials, comparing open prostatectomy with either Holmium Laser Enucleation of the Prostate (HoLEP) or bipolar enucleation of the prostate (BipoLEP). Prior to that, HoLEP was embraced as the only valid option for transurethral enucleation, although evidence for equivalence existed as early as 2006, but was not recognized due to a plethora of acronyms for bipolar energy-based treatments and practiced HoLEP-centrism. On the other hand, the academic discourse focused on different (other) laser approaches that came up, led by Thulium:Yttrium-Aluminum-Garnet (Tm:YAG) Vapoenucleation (ThuVEP) in 2009 and, finally, transurethral anatomical enucleation with Tm:YAG support (thulium laser enucleation of the prostate, ThuLEP) in 2010. Initially, the discourse on lasers focused on the different properties of lasers rather than technique or surgical anatomy, respectively. In and after 2016, the discussion ultimately moved towards surgical technique and accepting anatomical preparation as the common of all EEP techniques (AEEP). Since then, the unspoken question has been raised, whether lasers are still necessary to perform EEP in light of existing evidence, given the total cost of ownership (TCO) for these generators. This article weighs the current evidence and comes to the conclusion that no evidence of superiority of one modality over another exists with regard to any endpoint. Therefore, in the sense of critical importance, AEEP can be safely and effectively performed without laser technologies and without compromise.
dc.identifier.citationHerrmann, T. R. W., Gravas, S., de la Rosette, J. J. M. C. H., Wolters, M., Anastasiadis, A. G. ve Giannakis, I. (2020). Lasers in transurethral enucleation of the prostate-do we really need them. Journal of Clinical Medicine, 9(5). https://dx.doi.org/10.3390/jcm9051412
dc.identifier.doi10.3390/jcm9051412
dc.identifier.issn2077-0383
dc.identifier.issue5
dc.identifier.scopusqualityN/A
dc.identifier.urihttps://dx.doi.org/10.3390/jcm9051412
dc.identifier.urihttps://hdl.handle.net/20.500.12511/5446
dc.identifier.volume9
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherMultidisciplinary Digital Publishing Institute
dc.relation.ispartofJournal of Clinical Medicineen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsAttribution 4.0 International*
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/*
dc.subjectHolep
dc.subjectThulep
dc.subjectThuvep
dc.subjectGreenlep
dc.subjectVapoenucleation
dc.subjectAEEP
dc.subjectEEP
dc.subjectLaser
dc.subjectHolmium
dc.subjectThulium
dc.subjectDiode
dc.subjectGreenlight
dc.subjectLBO
dc.titleLasers in transurethral enucleation of the prostate-do we really need them
dc.typeArticle

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