Mp46-19 Functional Outcomes of Combined Single Session Holmium Laser Enucleation of Prostate and High Intensity Focused Ultrasound in Management of Prostate Cancer Patients With Large Prostate: A Comparative Study

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology III (MP46)1 May 2024MP46-19 FUNCTIONAL OUTCOMES OF COMBINED SINGLE SESSION HOLMIUM LASER ENUCLEATION OF PROSTATE AND HIGH INTENSITY FOCUSED ULTRASOUND IN MANAGEMENT OF PROSTATE CANCER PATIENTS WITH LARGE PROSTATE: A COMPARATIVE STUDY Ruben Blachman-Braun, Joao G. Porto, Tarek Ajami, Mohamadhusni Zarli, Ryan Chen, Diana M. Lopategui, Robert R. Marcovich, Dipen J. Parekh, Bruno Nahar, and Hemendra N. Shah Ruben Blachman-BraunRuben Blachman-Braun , Joao G. PortoJoao G. Porto , Tarek AjamiTarek Ajami , Mohamadhusni ZarliMohamadhusni Zarli , Ryan ChenRyan Chen , Diana M. LopateguiDiana M. Lopategui , Robert R. MarcovichRobert R. Marcovich , Dipen J. ParekhDipen J. Parekh , Bruno NaharBruno Nahar , and Hemendra N. ShahHemendra N. Shah View All Author Informationhttps://doi.org/10.1097/01.JU.0001008668.53858.38.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In patients with prostate cancer and large prostates undergoing focal therapy with High-Intensity Focused Ultrasound (HIFU), simultaneous benign prostatic hyperplasia (BPH) surgery has been used to improve immediate post-operative voiding symptoms. However, no studies have described the combined Holmium laser enucleation of the prostate HoLEP+HIFU in the focal treatment of Pca. In this study, we aimed to evaluate the functional outcomes and characteristics of patients undergoing simultaneous HoLEP+HIFU and compare them to those who underwent HoLEP for bladder outlet obstruction secondary to BPH. METHODS: A chart review of the IRB approved prospectively maintained database at our institution was performed to identify patients undergoing HoLEP+HIFU or HoLEP between January 2016 and January 2023. HoLEP procedures were performed using the "En-bloc" technique at 60 W energy settings. HIFU was performed with Ablatherm HIFU or Focal One devices immediately following HoLEP. Demographic, perioperative, functional characteristics, and complications of patients undergoing the combined procedure for Pca were compared with patients undergoing HoLEP for BPH. Statistical analysis was performed with SPSS version 28 software. RESULTS: A total of 505 patients were analyzed. Age, BMI, and preoperative prostate size were similar between both groups (Table 1). Patients who underwent HoLEP and HIFU had a higher rate of blood transfusion and postoperative acute urinary retention (AUR) (p<0.05). Postoperative UTI, urethral stricture, bladder neck stenosis, and continence rate were similar between the groups. Baseline IPSS was higher in the HoLEP group. However, at 6- and 12-months follow-up, the patients who underwent HoLEP+HIFU had higher IPPS (p<0.05) (Table 2). CONCLUSIONS: Patients who underwent HoLEP+HIFU had a higher rate of blood transfusion, postoperative AUR, and IPSS score on follow-up. The addition of HIFU to HoLEP does not seem to influence the rate of UTI, urethral stricture, or bladder neck stenosis, or continence. Source of Funding: No © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e760 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Ruben Blachman-Braun More articles by this author Joao G. Porto More articles by this author Tarek Ajami More articles by this author Mohamadhusni Zarli More articles by this author Ryan Chen More articles by this author Diana M. Lopategui More articles by this author Robert R. Marcovich More articles by this author Dipen J. Parekh More articles by this author Bruno Nahar More articles by this author Hemendra N. Shah More articles by this author Expand All Advertisement PDF downloadLoading ...