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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">HoLEP: the gold standard for the surgical management of BPH in the 21<sup>st</sup> Century</title><author><name sortKey="Michalak, John" sort="Michalak, John" uniqKey="Michalak J" first="John" last="Michalak">John Michalak</name></author><author><name sortKey="Tzou, David" sort="Tzou, David" uniqKey="Tzou D" first="David" last="Tzou">David Tzou</name></author><author><name sortKey="Funk, Joel" sort="Funk, Joel" uniqKey="Funk J" first="Joel" last="Funk">Joel Funk</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26069886</idno><idno type="pmc">4446381</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4446381</idno><idno type="RBID">PMC:4446381</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000019</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000019</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">HoLEP: the gold standard for the surgical management of BPH in the 21<sup>st</sup> Century</title><author><name sortKey="Michalak, John" sort="Michalak, John" uniqKey="Michalak J" first="John" last="Michalak">John Michalak</name></author><author><name sortKey="Tzou, David" sort="Tzou, David" uniqKey="Tzou D" first="David" last="Tzou">David Tzou</name></author><author><name sortKey="Funk, Joel" sort="Funk, Joel" uniqKey="Funk J" first="Joel" last="Funk">Joel Funk</name></author></analytic><series><title level="j">American Journal of Clinical and Experimental Urology</title><idno type="eISSN">2330-1910</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><italic>Introduction:</italic> For many years, transurethral resection of the prostate (TURP) has been accepted as the gold standard to surgically alleviate obstructive voiding dysfunction in men with benign prostatic hyperplasia (BPH). This historical standard has been challenged repeatedly over the last decade by consistent data demonstrating the superiority of Holmium enucleation of the prostate (HoLEP). This review summarizes the literature comparing HoLEP and traditional therapies for BPH that are widely used and have long term efficacy data, primarily TURP, open prostatectomy (OP), and alternative laser therapies (PVP, ThuLEP, etc). <italic>Results:</italic> Patients undergoing HoLEP have greater improvements in post-operative Qmax, greater reduction in post-operative subjective symptom scores, and lower rates of repeat endoscopic procedures for recurrent symptoms at 5-10 year follow up compared with TURP, OP, and other laser therapies. Furthermore, patients undergoing HoLEP benefit from significantly shortened catheterization times, decreased length of hospital stay (LOS), and fewer serious post-operative complications. In particular, randomized controlled trials (RCT) have demonstrated that HoLEP can be used to resect adenomas greater than 100 grams with equivalent efficacy to open prostatectomy, but with radically decreased morbidity. <italic>Conclusion:</italic> Numerous large, RCTs demonstrate HoLEP to be objectively superior to other surgical therapies for BPH. The urologic community should embrace HoLEP as the new gold standard for surgical BPH therapy, especially in men with large prostates who would otherwise be considered for an OP or staged TURP. The only obstacle to widespread implementation of HoLEP remains its difficult learning curve when compared with traditional transurethral resection. Further allocation of resources towards appropriate mentoring and teaching of HoLEP is warranted, particularly in residency training programs.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Am J Clin Exp Urol</journal-id><journal-id journal-id-type="iso-abbrev">Am J Clin Exp Urol</journal-id><journal-id journal-id-type="publisher-id">ajceu</journal-id><journal-title-group><journal-title>American Journal of Clinical and Experimental Urology</journal-title></journal-title-group><issn pub-type="epub">2330-1910</issn><publisher><publisher-name>e-Century Publishing Corporation</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26069886</article-id><article-id pub-id-type="pmc">4446381</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject></subj-group></article-categories><title-group><article-title>HoLEP: the gold standard for the surgical management of BPH in the 21<sup>st</sup> Century</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Michalak</surname><given-names>John</given-names></name></contrib><contrib contrib-type="author"><name><surname>Tzou</surname><given-names>David</given-names></name></contrib><contrib contrib-type="author"><name><surname>Funk</surname><given-names>Joel</given-names></name></contrib><aff><institution>Division of Urology, University of Arizona School of Medicine</institution><addr-line>PO Box 245077, 1501 North Campbell Ave, Tucson, AZ 85724</addr-line></aff></contrib-group><author-notes><corresp><bold>Address correspondence to:</bold> Dr. Joel Funk, Division of Urology, University of Arizona School of Medicine, PO Box 245077, 1501 North Campbell Ave, Tucson, AZ 85724. Tel: 520-626-4459; Fax: 520-626-4493; E-mail: <email>jfunk@surgery.arizona.edu</email></corresp></author-notes><pub-date pub-type="collection"><year>2015</year></pub-date><pub-date pub-type="epub"><day>25</day><month>4</month><year>2015</year></pub-date><volume>3</volume><issue>1</issue><fpage>36</fpage><lpage>42</lpage><history><date date-type="received"><day>24</day><month>2</month><year>2015</year></date><date date-type="accepted"><day>01</day><month>4</month><year>2015</year></date></history><permissions><copyright-statement>AJCEU Copyright © 2015</copyright-statement><copyright-year>2015</copyright-year></permissions><abstract><p><italic>Introduction:</italic> For many years, transurethral resection of the prostate (TURP) has been accepted as the gold standard to surgically alleviate obstructive voiding dysfunction in men with benign prostatic hyperplasia (BPH). This historical standard has been challenged repeatedly over the last decade by consistent data demonstrating the superiority of Holmium enucleation of the prostate (HoLEP). This review summarizes the literature comparing HoLEP and traditional therapies for BPH that are widely used and have long term efficacy data, primarily TURP, open prostatectomy (OP), and alternative laser therapies (PVP, ThuLEP, etc). <italic>Results:</italic> Patients undergoing HoLEP have greater improvements in post-operative Qmax, greater reduction in post-operative subjective symptom scores, and lower rates of repeat endoscopic procedures for recurrent symptoms at 5-10 year follow up compared with TURP, OP, and other laser therapies. Furthermore, patients undergoing HoLEP benefit from significantly shortened catheterization times, decreased length of hospital stay (LOS), and fewer serious post-operative complications. In particular, randomized controlled trials (RCT) have demonstrated that HoLEP can be used to resect adenomas greater than 100 grams with equivalent efficacy to open prostatectomy, but with radically decreased morbidity. <italic>Conclusion:</italic> Numerous large, RCTs demonstrate HoLEP to be objectively superior to other surgical therapies for BPH. The urologic community should embrace HoLEP as the new gold standard for surgical BPH therapy, especially in men with large prostates who would otherwise be considered for an OP or staged TURP. The only obstacle to widespread implementation of HoLEP remains its difficult learning curve when compared with traditional transurethral resection. Further allocation of resources towards appropriate mentoring and teaching of HoLEP is warranted, particularly in residency training programs.</p></abstract><kwd-group><kwd>HoLEP</kwd><kwd>holmium</kwd><kwd>laser</kwd><kwd>enucleation</kwd><kwd>benign prostatic hyperplasia</kwd><kwd>transurethral resection of prostate</kwd><kwd>open prostatectomy</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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