Current surgical techniques of enucleation in holmium laser enucleation of the prostate

• Published in: Investigative and clinical urology Vol. 60; no. 5; pp. 333 - 342
• Main Author: Oh, Seung-June
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Urological Association 01.09.2019; Korean Urological Association; 대한비뇨의학회
• Subjects: Enucleation; Holmium; Humans; Laser therapy; Lasers, Solid-State - therapeutic use; Male; Prostatectomy - methods; Prostatic hyperplasia; Prostatic Hyperplasia - surgery; Review; Transurethral resection of prostate; 비뇨기과학; Enucleation; Prostatic hyperplasia; Transurethral resection of prostate; Laser therapy; Holmium
• ISSN: 2466-0493; 2466-054X; 2466-054X
• DOI: 10.4111/icu.2019.60.5.333

Holmium laser enucleation of the prostate (HoLEP) has been accepted as the most efficient method of transurethral surgery for benign prostatic hyperplasia. The originally developed three-lobe technique has popularized this surgery; this method is based on three longitudinal incisions, by which the median lobe is removed, and subsequently, both lateral lobes are enucleated. To maintain a consistent surgical plane and to minimize sphincteric damage, the traditional three-lobe technique is continuously being refined and evolving. A few modifications of the original technique have been developed, and several enucleation methods have been introduced. However, more clinical evidence is required to show the superiority of newer techniques over the original three-lobe technique in terms of efficacy and long-term side effects. To date, none of the newer techniques have been accepted as a standard technique for HoLEP.