Abstract

Purpose

Holmium-laser enucleation of the prostate (HoLEP) has been a promising prostate surgery since its first introduction. Although there are 10 different HoLEP techniques in the literature, stress urinary incontinence (SUI) is common, because surgery is not performed based on the topographic anatomy of the external sphincter. We have developed a new HoLEP method named as the ‘’Omega Sign technique”, which is based on the topographic anatomy of the external sphincter and could provide better continence outcomes by decreasing SUI rates.

Materials and methods

The data of 400 patients who underwent HoLEP by a single surgeon between May 2016 and February 2019 were retrospectively reviewed. The patients were divided into two groups, the first underwent the Gilling’s technique (Group 1) and the second the novel ‘’Omega Sign’’ technique (Group 2). Continence status and post-micturition symptoms (PMS) were evaluated according to the standards recommended by the international continence status.

Results

The data of 400 HoLEP procedures between May 2016 and February 2019 were analyzed, comparing Group 1 (n = 200) and Group 2(n = 200). SUI rate was significantly lower in Group 2 at the day of catheter removal and first month (p < 0.005). In addition, urge urinary incontinence (UUI) rate and PMS were significantly lower in Group 2.

Conclusions

We could demonstrate improved continence results, comparable functional outcomes and equally minimal complications with the standard HoLEP technique. We believe that, the novel ‘Omega sign’ technique decreases SUI rates and will become standardised and easy to understand, thereby bringing and creating a shorter learning curve.

中文翻译：

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“Omega Sign”：一种新颖的 HoLEP 技术，可改善去核后的失禁结果

摘要

目的

钬激光前列腺摘除术 (HoLEP) 自首次推出以来一直是一种很有前途的前列腺手术。尽管文献中有 10 种不同的 HoLEP 技术，但压力性尿失禁 (SUI) 很常见，因为手术不是根据外括约肌的地形解剖进行的。我们开发了一种名为“Omega Sign 技术”的新 HoLEP 方法，该方法基于外括约肌的地形解剖学，可以通过降低 SUI 率来提供更好的节制结果。

材料和方法

回顾性分析了 2016 年 5 月至 2019 年 2 月期间由一名外科医生接受 HoLEP 的 400 名患者的数据。患者被分为两组，第一组接受 Gilling 技术（第 1 组），第二组接受新型“Omega Sign”技术（第 2 组）。根据国际尿控状态推荐的标准评估尿控状态和排尿后症状（PMS）。

结果

分析了 2016 年 5 月至 2019 年 2 月期间 400 次 HoLEP 程序的数据，比较了第 1 组（n  = 200）和第 2 组（n  = 200）。在拔管当天和第一个月，第 2 组的 SUI 率显着降低 ( p  < 0.005)。此外，第 2 组的急迫性尿失禁 (UUI) 率和 PMS 显着降低。

结论

我们可以证明标准 HoLEP 技术改善了节制结果、可比较的功能结果和同样最小的并发症。我们相信，新颖的“欧米茄标志”技术降低了 SUI 率，并将变得标准化和易于理解，从而带来并创造更短的学习曲线。