Transurethral Holmium Laser Enucleation Versus Transvesical Open Enucleation for Prostate Adenoma Greater Than 100 gm.: A Randomized Prospective Trial of 120 Patients

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Oct 2002Transurethral Holmium Laser Enucleation Versus Transvesical Open Enucleation for Prostate Adenoma Greater Than 100 gm.: A Randomized Prospective Trial of 120 Patients Rainer M. Kuntz and Karin Lehrich Rainer M. KuntzRainer M. Kuntz More articles by this author and Karin LehrichKarin Lehrich More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64475-8AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Prostate adenomas greater than 100 gm. have traditionally been treated with open prostatectomy. This procedure may involve considerable blood loss, morbidity, prolonged hospital stay and recovery time. The high powered holmium:YAG laser can be used endoscopically to enucleate obstructing prostatic tissue in a relatively bloodless manner. The technique of transurethral holmium laser enucleation of the prostate is compared to open prostatectomy for the surgical management of large prostate adenomas in a prospective randomized study. Materials and Methods: A total of 120 urodynamically obstructed patients with a prostate larger than 100 gm. on transrectal ultrasound were randomized to undergo holmium laser enucleation of the prostate or open prostatectomy. All patients were assessed preoperatively and 1, 3 and 6 months postoperatively. Patient baseline characteristics, perioperative data and postoperative outcome were compared. All complications were noted. Results: Holmium laser enucleation of the prostate and open prostatectomy resulted in a similar and significant improvement in American Urological Association symptom scores, peak urinary flow rates and post-void residual urine volumes. Operating time was significantly longer in the holmium group but blood loss was significantly less, and catheterization time and hospital stay were significantly shorter. Effects on continence and potency were similar in both groups but adverse events were less frequent in the holmium group. None of the holmium group patients needed blood transfusions in contrast to 8 patients in the prostatectomy group. Conclusions: Holmium laser enucleation of the prostate and open prostatectomy are equally effective procedures for removal of large prostatic adenomas. Holmium laser enucleation resulted in significantly less perioperative morbidity and may become the endourological alternative to open prostatectomy. References 1 : Holmium laser enucleation for prostate adenoma greater than 100 gm.: comparison to open prostatectomy. J Urol2001; 165: 459. Link, Google Scholar 2 : Laser prostatectomy with the holmium: YAG laser. Tech Urol1995; 1: 217. Medline, Google Scholar 3 : Holmium laser resection of the prostate: preliminary results of a new method for the treatment of benign prostatic hyperplasia. Urology1996; 47: 48. Crossref, Medline, Google Scholar 4 : Transurethrale holmium-laser-resektion der prostata (HoLRP) und holmium-laser-enukleation der prostata (HoLEP). Akt Urol1998; 29: 139. Crossref, Google Scholar 5 : The use of the holmium laser in the treatment of benign prostatic hyperplasia. J Endourol1996; 10: 459. Crossref, Medline, Google Scholar 6 : Holmium: YAG laser enucleation of the prostate combined with mechanical morcellation: preliminary results. Eur Urol1998; 33: 69. Crossref, Medline, Google Scholar 7 : Holmium laser enucleation of the prostate (HoLEP) combined with transurethral tissue morcellation: an update on the early clinical experience. J Endourol1998; 12: 457. Crossref, Medline, Google Scholar 8 : Holmium laser resection of the prostate. J Endourol1998; 12: 279. Crossref, Medline, Google Scholar 9 : Transurethral resection of the prostate with the holmium contact laser. Progress in treatment of benign prostatic hypertrophy? Urologe A1999; 38: 156. Google Scholar 10 : Results of holmium laser resection of the prostate for benign prostatic hyperplasia. J Endourol2000; 14: 533. Crossref, Medline, Google Scholar 11 : Holmium laser versus transurethral resection of the prostate: a randomized prospective trial with 1 year follow-up. J Urol1999; 162: 1640. Link, Google Scholar 12 : Holmium laser resection v transurethral resection of the prostate: results of a randomized trial with 2 years of follow-up. J Endourol2000; 14: 757. Crossref, Medline, Google Scholar 13 : Transurethral holmium laser enucleation of the prostate (HOLEP) compared to classical transurethral resection of the prostate (TURP): a randomized pro-spective trial in patients with prostates smaller than 100 grams. Med Laser Appl2001; 16: 165. Google Scholar 14 : Transurethral holmium-laser- enucleation (HoLEP) of large prostate glands. J Endourol1999; 13: A99. Medline, Google Scholar 15 : Holmium laser enucleation of the prostate for glands larger than 100 g: an endourologic alternative to open prostatectomy. J Endourol2000; 14: 529. Crossref, Medline, Google Scholar 16 : Transurethral holmium laser enucleation of the prostate (HoLEP)—a prospective study on 100 patients with one year follow-up. Med Laser Appl2001; 16: 15. Crossref, Google Scholar 17 Kuntz, R.M., Lehrich, K., Fayad, A., Transurethral holmium laser enucleation of prostates (HoLEP) larger than 80 grams. In Proceedings. R.R., Anderson. Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems XI. vol. 4244. SPIE, 2001, 317 Google Scholar 18 Kuntz R.M. Lehrich K. Transurethral holmium laser enucleation of the prostate (HoLEP) combined with mechanical tissue morcellation. Submitted for publication Google Scholar 19 : Histologic effects of holmium: YAG laser resection versus transurethral resection of the prostate. J Endourol2000; 14: 459. Crossref, Medline, Google Scholar 20 : Clinical Practice Guideline: Benign Prostatic Hyperplasia: Diagnosis and Treatment. Rockville: Agency for Health Care Policy and Research, Public Health Service, Publication No. 94-05821994; . Google Scholar From the Urology Department, Auguste-Viktoria-Hospital, Berlin, Germany© 2002 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited by Elsaqa M, Elgebaly O, Sakr M, Youssif T, Rashad H and El Tayeb M (2022) Comparison of outcomes of holmium laser versus bipolar enucleation of prostates weighing >80 g with bladder outlet obstructionBaylor University Medical Center Proceedings, 10.1080/08998280.2022.2116764, VOL. 36, NO. 1, (15-19), Online publication date: 2-Jan-2023. Wymer K, Narang G, Slade A, Sharma V, Thao V, Borah B, Rivera M, Cheney S and Humphreys M (2023) Evaluation of the Cost-Effectiveness of Surgical Treatment Options for Benign Prostatic HyperplasiaUrology, 10.1016/j.urology.2022.09.026, VOL. 171, (96-102), Online publication date: 1-Jan-2023. Laughlin B, Narang G, Cheney S, Humphreys M, Vargas C, Keole S, Rwigema J, Schild S and Wong W (2022) Toxicity and outcomes after external beam irradiation for prostate cancer in patients with prior holmium laser enucleation of the prostate: Early experienceCancer Reports, 10.1002/cnr2.1672, VOL. 6, NO. 1, Online publication date: 1-Jan-2023. Lee M, Assmus M, Ganesh M, Han J, Helon J, Mai Q, Mi X and Krambeck A (2022) An Outcomes Comparison Between Holmium Laser Enucleation of the Prostate, Open Simple Prostatectomy, and Robotic Simple Prostatectomy for Large Gland Benign Prostatic HypertrophyUrology, 10.1016/j.urology.2022.12.018, Online publication date: 1-Dec-2022. Siddiqui S and Welliver C (2022) Preserving Sexual Function in Men with LUTS Secondary to Large ProstatesThe Journal of Sexual Medicine, 10.1016/j.jsxm.2022.04.008, VOL. 19, NO. 8, (1221-1224), Online publication date: 1-Aug-2022. Sun F, Yao H, Bao X, Wang X, Wang D, Zhang D, Zhou Z and Wu J (2022) The Efficacy and Safety of HoLEP for Benign Prostatic Hyperplasia With Large Volume: A Systematic Review and Meta-AnalysisAmerican Journal of Men's Health, 10.1177/15579883221113203, VOL. 16, NO. 4, (155798832211132), Online publication date: 1-Jul-2022. Gury L, Mallet R and Robert G (2022) Holmium laser en-bloc enucleation of the prostate: Bi-centric prospective evaluation of 109 consecutive casesProgrès en Urologie, 10.1016/j.purol.2021.01.009, VOL. 32, NO. 2, (121-129), Online publication date: 1-Feb-2022. Wei H, Guo B, Tu Y, Hu X, Zheng W, Zhang D and Zhuo J (2022) Comparison of the efficacy and safety of transurethral laser versus open prostatectomy for patients with large-sized benign prostatic hyperplasia: A meta-analysis of comparative trialsInvestigative and Clinical Urology, 10.4111/icu.20210281, VOL. 63, NO. 3, (262), . Chang C, Lee C, Lin C, Li C, Wen S, Yeh H and Geng J (2022) Monopolar transurethral resection of the prostate versus holmium laser enucleation in men with prostate volume greater than 100 mLUrological Science, 10.4103/UROS.UROS_114_21, VOL. 33, NO. 2, (70), . Pallauf M, Kunit T, Ramesmayer C, Deininger S, Herrmann T and Lusuardi L (2021) Endoscopic enucleation of the prostate (EEP). The same but different—a systematic reviewWorld Journal of Urology, 10.1007/s00345-021-03705-6, VOL. 39, NO. 7, (2383-2396), Online publication date: 1-Jul-2021. Reddy S, Utley V and Gilling P (2020) The Evolution of Endoscopic Prostate Enucleation: A historical perspective Andrologia, 10.1111/and.13673, VOL. 52, NO. 8, Online publication date: 1-Sep-2020. Aho T, Armitage J and Kastner C (2020) Anatomical endoscopic enucleation of the prostate: The next gold standard? Yes!Andrologia, 10.1111/and.13643, VOL. 52, NO. 8, Online publication date: 1-Sep-2020. Wei S, Cheng F and Yu W (2019) The clinical application of combination suprapubic prostatectomy with transurethral resection of the prostate (TURP) in patients with large volume benign prostatic hyperplasia (BPH)Urologia Journal, 10.1177/0391560319834492, VOL. 87, NO. 2, (65-69), Online publication date: 1-May-2020. Large T and Krambeck A (2020) Holmium Laser Enucleation of the Prostate (HoLEP) Minimally Invasive Urology, 10.1007/978-3-030-23993-0_15, (241-252), . Bell C, Moore S, Gill A, Obi-Njoku O, Hughes S, Saleemi A, Ellis G, Khan F and Shergill I (2019) Safety and efficacy of Holmium laser enucleation of the prostate (HoLEP) in patients with previous transperineal biopsy (TPB): outcomes from a dual-centre case-control studyBMC Urology, 10.1186/s12894-019-0523-z, VOL. 19, NO. 1, Online publication date: 1-Dec-2019. Chang C, Lin T and Huang J (2019) Safety and effectiveness of high-power thulium laser enucleation of the prostate in patients with glands larger than 80 mLBMC Urology, 10.1186/s12894-019-0437-9, VOL. 19, NO. 1, Online publication date: 1-Dec-2019. Zhang Y, Yuan P, Ma D, Gao X, Wei C, Liu Z, Li R, Wang S, Liu J and Liu X (2019) Efficacy and safety of enucleation vs. resection of prostate for treatment of benign prostatic hyperplasia: a meta-analysis of randomized controlled trialsProstate Cancer and Prostatic Diseases, 10.1038/s41391-019-0135-4, VOL. 22, NO. 4, (493-508), Online publication date: 1-Dec-2019. Nestler S, Bach T, Herrmann T, Jutzi S, Roos F, Hampel C, Thüroff J, Thomas C and Neisius A (2018) Surgical treatment of large volume prostates: a matched pair analysis comparing the open, endoscopic (ThuVEP) and robotic approachWorld Journal of Urology, 10.1007/s00345-018-2585-z, VOL. 37, NO. 9, (1927-1931), Online publication date: 1-Sep-2019. Park I and Kim T (2018) Second to fourth digit ratio and lung function (forced vital capacity): predictors of maximum urinary flow rate after holmium laser enucleation of the prostateAndrology, 10.1111/andr.12564, VOL. 7, NO. 2, (172-177), Online publication date: 1-Mar-2019. Zhao F, Zhang C, Yan J, Li Y, Yang Y and Sun D (2018) Effects of Qianlie Tongqiao Capsule on Bladder Weight and Growth Factors in Bladder Tissue of Rats with Testosterone-Induced Benign Prostatic HyperplasiaEvidence-Based Complementary and Alternative Medicine, 10.1155/2018/5059267, VOL. 2018, (1-10), Online publication date: 5-Nov-2018. Enikeev D, Glybochko P, Rapoport L, Gahan J, Gazimiev M, Spivak L, Enikeev M and Taratkin M (2018) A Randomized Trial Comparing The Learning Curve of 3 Endoscopic Enucleation Techniques (HoLEP, ThuFLEP, and MEP) for BPH Using Mentoring Approach—Initial ResultsUrology, 10.1016/j.urology.2018.06.045, VOL. 121, (51-57), Online publication date: 1-Nov-2018. SHIN D, KIM H, PARK S, PARK C, CHOI S, OH T, LEE D, LEE C, KIM J and LEE J (2017) New Surgical Instruction Method for Homium Laser Enucleation of the Prostate, “Hand-Grab Navigated Technique,” to Shorten the Learning Curve: The Results of Multicenter AnalysisLUTS: Lower Urinary Tract Symptoms, 10.1111/luts.12172, VOL. 10, NO. 3, (247-252), Online publication date: 1-Sep-2018. Mallet R (2018) Les traitements par laser de l’hyperplasie bénigne de la prostateBulletin de l'Académie Nationale de Médecine, 10.1016/S0001-4079(19)30215-8, VOL. 202, NO. 7, (1487-1499), Online publication date: 1-Sep-2018. Shah A, Gahan J and Sorokin I (2018) Comparison of Robot-Assisted Versus Open Simple Prostatectomy for Benign Prostatic HyperplasiaCurrent Urology Reports, 10.1007/s11934-018-0820-1, VOL. 19, NO. 9, Online publication date: 1-Sep-2018. Gu M, Liu C, Chen Y, Xu H, Fu S, Chen Q and Wang Z (2018) Comparison of Vela and holmium laser enucleation of the prostate: a retrospective clinical trial with a 12-month follow-upInternational Urology and Nephrology, 10.1007/s11255-018-1840-y, VOL. 50, NO. 5, (819-823), Online publication date: 1-May-2018. Lanchon C, Fiard G, Long J, Arnoux V, Carnicelli D, Franquet Q, Poncet D, Bey E, Lefrancq J, Grisard S, Peilleron N, Terrier N, Boillot B, Rambeaud J, Descotes J and Thuillier C (2018) Open prostatectomy versus 180-W XPS GreenLight laser vaporization: Long-term functional outcome for prostatic adenomas > 80 gProgrès en Urologie, 10.1016/j.purol.2017.12.008, VOL. 28, NO. 3, (180-187), Online publication date: 1-Mar-2018. Kim K, Kim K, Oh J, Chung K, Yoon S, Jung H and Kim T (2018) Enucleated Weight/Enucleation Time, Is It Appropriate for Estimating Enucleation Skills for Holmium Laser Enucleation of the Prostate? A Consideration of Energy ConsumptionThe World Journal of Men's Health, 10.5534/wjmh.17039, VOL. 36, NO. 1, (79), . Lipsky M, Small A, Mlynarczyk C, Badalato G and Rutman M (2018) Open Prostatectomy A Comprehensive Guide to the Prostate, 10.1016/B978-0-12-811464-3.00014-3, (107-120), . Kuntz R (2018) Holmium-Laser-Enukleation der Prostata (HoLEP) Endoskopische Urologie, 10.1007/978-3-662-53981-1_9, (123-152), . Iremashvili V and Marcovich R (2018) Laser Applications in Urology Lasers in Dermatology and Medicine, 10.1007/978-3-319-76220-3_8, (163-177), . Vedanayagam M and Dickinson I (2018) Surgical Treatment: Transurethral Resection of the Prostate The Big Prostate, 10.1007/978-3-319-64704-3_9, (117-128), . Catterwell R, Popert R and Challacombe B (2018) Surgical Treatment: Enucleation of the Prostate The Big Prostate, 10.1007/978-3-319-64704-3_7, (87-103), . Noguera R, Pérez J and Canes D (2018) Difficulties in Laparoscopic Simple Prostatectomy Difficult Conditions in Laparoscopic Urologic Surgery, 10.1007/978-3-319-52581-5_14, (163-182), . Rivera M, Lingeman J and Krambeck A (2017) Re: Surgical Options for the Enlarged, Obstructing, Benign ProstateJournal of Urology, VOL. 198, NO. 4, (944-945), Online publication date: 1-Oct-2017. Hiraoka Y (2017) Transurethral endoscopic enucleation of the prostate (EEP)World Journal of Urology, 10.1007/s00345-017-2019-3, VOL. 35, NO. 10, (1629-1630), Online publication date: 1-Oct-2017. Zhang M, El Tayeb M, Borofsky M, Dauw C, Wagner K, Lowry P, Bird E, Hudson T and Lingeman J (2017) Comparison of Perioperative Outcomes Between Holmium Laser Enucleation of the Prostate and Robot-Assisted Simple ProstatectomyJournal of Endourology, 10.1089/end.2017.0095, VOL. 31, NO. 9, (847-850), Online publication date: 1-Sep-2017. Gilling P (2016) Editorial CommentJournal of Urology, VOL. 197, NO. 4, (1113-1114), Online publication date: 1-Apr-2017. Häcker A and Thüroff J (2016) Langzeitergebnisse nach roboterassistierter AdenomenukleationLong-term results after robot-assisted adenoma enucleationDer Urologe, 10.1007/s00120-016-0251-x, VOL. 55, NO. 11, (1455-1461), Online publication date: 1-Nov-2016. Singla N and Singla A (2016) Evaluation and Management of Lower Urinary Tract Symptoms After Outlet Surgery for Benign Prostatic HyperplasiaCurrent Bladder Dysfunction Reports, 10.1007/s11884-016-0376-1, VOL. 11, NO. 3, (242-247), Online publication date: 1-Sep-2016. Scoffone C and Cracco C (2015) The en-bloc no-touch holmium laser enucleation of the prostate (HoLEP) techniqueWorld Journal of Urology, 10.1007/s00345-015-1741-y, VOL. 34, NO. 8, (1175-1181), Online publication date: 1-Aug-2016. Elshal A, Eldemerdash Y, Mekkawy R, Taha D, Laymon M, El-Nahas A and El-Assmy A (2019) Prostate tissue retrieval after holmium laser enucleation of the prostate; assessment of non-morcellation approachesArab Journal of Urology, 10.1016/j.aju.2016.02.003, VOL. 14, NO. 2, (147-155), Online publication date: 1-Jun-2016. Robert G, Cornu J, Fourmarier M, Saussine C, Descazeaud A, Azzouzi A, Vicaut E and Lukacs B (2015) Multicentre prospective evaluation of the learning curve of holmium laser enucleation of the prostate (HoLEP)BJU International, 10.1111/bju.13124, VOL. 117, NO. 3, (495-499), Online publication date: 1-Mar-2016. Jones P, Alzweri L, Rai B, Somani B, Bates C and Aboumarzouk O (2019) Holmium laser enucleation versus simple prostatectomy for treating large prostates: Results of a systematic review and meta-analysisArab Journal of Urology, 10.1016/j.aju.2015.10.001, VOL. 14, NO. 1, (50-58), Online publication date: 1-Mar-2016. Elshal A, Mekkawy R, Laymon M, Barakat T, Elsaadany M, El-Assmy A and El-Nahas A (2015) Holmium laser enucleation of the prostate for treatment for large-sized benign prostate hyperplasia; is it a realistic endourologic alternative in developing country?World Journal of Urology, 10.1007/s00345-015-1639-8, VOL. 34, NO. 3, (399-405), Online publication date: 1-Mar-2016. Griebling T (2015) Re: The Role of the Bipolar PlasmaKinetic TURP over 100 g Prostate in the Elderly PatientsJournal of Urology, VOL. 195, NO. 2, (423-423), Online publication date: 1-Feb-2016. Kava B, Mettu J, Bhatia S, Mohan P and Badlani G (2016) Treatments for Benign Conditions of the Prostate Gland Interventional Urology, 10.1007/978-3-319-23464-9_16, (197-218), . Soto-Mesa D, Amorín-Díaz M, Pérez-Arviza L, Fernández-Pello Montes S and Martín-Huéscar A (2015) Holmium laser enucleation of the prostate vs. retropubic prostatic adenomectomy: Morbidity analysis and anesthesia considerationsActas Urológicas Españolas (English Edition), 10.1016/j.acuroe.2015.09.007, VOL. 39, NO. 9, (535-545), Online publication date: 1-Nov-2015. Soto-Mesa D, Amorín-Díaz M, Pérez-Arviza L, Fernández-Pello Montes S and Martín-Huéscar A (2015) Enucleación prostática con láser holmio y adenomectomía prostática retropúbica: análisis de morbilidad y consideraciones anestésicasActas Urológicas Españolas, 10.1016/j.acuro.2015.03.005, VOL. 39, NO. 9, (535-545), Online publication date: 1-Nov-2015. Montorsi F and Gandaglia G (2015) Re: Riccardo Autorino, Homayoun Zagar, Mirandolino B. Mariano, et al. Perioperative Outcomes of Robotic and Laparoscopic Simple Prostatectomy: A European–American Multi-institutional Analysis. Eur Urol 2015;68:86–94Re: Matthew Bultitude, Ben Challacombe. Simple Prostatectomy: A Step Too Far for Laparoscopy? Eur Urol 2015;68:95–6European Urology, 10.1016/j.eururo.2015.01.022, VOL. 68, NO. 1, (e7-e8), Online publication date: 1-Jul-2015. Saito K, Hisasue S, Ide H, Aoki H, Muto S, Yamaguchi R, Tsujimura A, Horie S and Ahmed A (2015) The Impact of Increased Bladder Blood Flow on Storage Symptoms after Holmium Laser Enucleation of the ProstatePLOS ONE, 10.1371/journal.pone.0129111, VOL. 10, NO. 6, (e0129111) Netsch C, Bach T, Herrmann T and Gross A (2014) Update on the current evidence for Tm:YAG vapoenucleation of the prostate 2014World Journal of Urology, 10.1007/s00345-014-1417-z, VOL. 33, NO. 4, (517-524), Online publication date: 1-Apr-2015. Li M, Qiu J, Hou Q, Wang D, Huang W, Hu C, Li K, Gao X and Schwentner C (2015) Endoscopic Enucleation versus Open Prostatectomy for Treating Large Benign Prostatic Hyperplasia: A Meta-Analysis of Randomized Controlled TrialsPLOS ONE, 10.1371/journal.pone.0121265, VOL. 10, NO. 3, (e0121265) Placer J, Salvador C, Planas J, Trilla E, Lorente D, Celma A, López M and Morote J (2015) Effects of Holmium Laser Enucleation of the Prostate on Sexual FunctionJournal of Endourology, 10.1089/end.2014.0502, VOL. 29, NO. 3, (332-339), Online publication date: 1-Mar-2015. Bravo-Castro E, Campos-Salcedo J, Rosas-Hernandez H, Torres-Gomez J, López-Silvestre J, Zapata-Villalba M, Estrada-Carrasco C, Díaz-Gomez C, Castelán-Martínez J, Martínez-Alonso I, Gil-Villa S and Dayan-Nurko M (2015) Técnica quirúrgica de la enucleación prostática con energía bipolar con asa TUEB: experiencia de 20 casosRevista Mexicana de Urología, 10.1016/j.uromx.2014.11.007, VOL. 75, NO. 1, (25-29), Online publication date: 1-Jan-2015. Bravo-Castro E, Campos-Salcedo J, Rosas-Hernandez H, Torres-Gomez J, López-Silvestre J, Zapata-Villalba M, Estrada-Carrasco C, Díaz-Gomez C, Castelán-Martínez J, Martínez-Alonso I, Gil-Villa S and Dayan-Nurko M (2015) Técnica quirúrgica de la enucleación prostática con energía bipolar con asa TUEB. Experiencia con el primer casoRevista Mexicana de Urología, 10.1016/j.uromx.2014.11.003, VOL. 75, NO. 1, (38-41), Online publication date: 1-Jan-2015. Kahokehr A and Gilling P (2015) Holmium Enucleation of Prostate Treatment of Benign Prostatic Hyperplasia: Modern Alternative to Transurethral Resection of the Prostate, 10.1007/978-1-4939-1587-3_10, (61-73), . Knoedler J and Krambeck A (2015) Holmium Laser Enucleation of the Prostate (HoLEP) Minimally Invasive Urology, 10.1007/978-1-4939-1317-6_17, (221-230), . Moon K, Kim D, Yoon J, Na W and Lee J (2014) Outcomes of the Holmium Laser Enucleation of the Prostate for Patients With Prior Benign Prostatic Hyperplasia SurgeryJournal of the Korean Geriatrics Society, 10.4235/jkgs.2014.18.4.199, VOL. 18, NO. 4, (199-204), Online publication date: 30-Dec-2015. Coskuner E, Ozkan T, Koprulu S, Dillioglugil O and Cevik I (2014) The role of the bipolar plasmakinetic TURP over 100 g prostate in the elderly patientsInternational Urology and Nephrology, 10.1007/s11255-014-0803-1, VOL. 46, NO. 11, (2071-2077), Online publication date: 1-Nov-2014. Fourmarier M, Faure A, Negre T, Arroua F and Eghazarian C (2014) Trucs et astuces. Énucléation de la prostate au laser holmium (HoLEP)Progrès en Urologie - FMC, 10.1016/j.fpurol.2014.03.002, VOL. 24, NO. 3, (F64-F67), Online publication date: O, Y, J, N and D (2014) Journal of Urology, VOL. NO. 3, Online publication date: Chen S, L, J, Zheng Z, R, Wu M, Z, Zhou H, Yang S, Wu W, L and J (2014) Enucleation of the Prostate with Open Prostatectomy for Than 100 A Randomized Controlled Trial with Long-term Results 6 Urology, VOL. NO. 2, Online publication date: S, de A, S, P, Park D, A, M, Gill I and M (2014) Transvesical Robotic Simple Prostatectomy: Clinical Urology, VOL. NO. 2, Online publication date: M Holmium laser enucleation of the prostate: a review of the clinical trial in Urology, VOL. 6, NO. 2, Online publication date: B, Y and A (2014) de la de bipolar y con - VOL. 14, NO. 1, Online publication date: A, A, L, R, H, F, R, T, D, O, M, M and S (2014) Holmium Laser Enucleation of the Prostate Is in Patients with Prostate Cancer and Lower Urinary Tract of Endourology, VOL. 28, NO. 3, Online publication date: M and A (2014) Laser treatment of benign prostate laser for Urology, VOL. 11, NO. 3, Online publication date: C, H, Y, H, B and S A prospective study comparing bipolar endoscopic enucleation of prostate with bipolar transurethral resection in for management of benign prostate larger than g in a matched Urology and Nephrology, VOL. 46, NO. 3, Online publication date: Kahokehr A and Gilling P (2014) Enucleation for