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Inicio Actas Urológicas Españolas (English Edition) Diode laser enucleation of the prostate (Dilep): technique and initial results
Journal Information
Vol. 35. Issue 1.
Pages 37-41 (January 2011)
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Vol. 35. Issue 1.
Pages 37-41 (January 2011)
Surgical Technique
Diode laser enucleation of the prostate (Dilep): technique and initial results
Enucleación prostática con láser de diodo (Dilep): técnica y resultados iniciales
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O. Buisan
Corresponding author
obuisan2903@gmail.com

Corresponding author.
, J.M. Saladie, J.M. Ruiz, S. Bernal, S. Bayona, L. Ibarz
Servicio de Urología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain
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Abstract
Introduction

We present our preliminary experience and results of practising the prostate enucleation technique using a diode laser (DiLEP) and intravesical morcellation, following the same principles of holmium laser enucleation (HoLEP).

Materials and method

We endoscopically treated benign prostate hyperplasia with DiLEP in 17 patients over a period of five months. They were all followed up for three months with flowmetry and IPSS. We have described the prostate enucleation and morcellation technique in detail, as well as the materials required to perform it. We have also commented on the lessons learned having practised on more than 300 cases with HoLEP, with a view to applying this new technology.

Results

The mean age was 74.2 and the mean prostate volume was 61.26 (47–110) cc. The mean loss of haemoglobin was 2.1 (1.4–3.1) gr/dl. There were no major consequences or complications. All the patients were discharged from hospital 24 hours after the operation. Improvement in the IPSS (22.3±4.1 vs. 7.1±1.06) and in the Q max (7.14±2.6 vs. 21.4±3.6) was sustainable.

Conclusions

It is the first description of the DiLEP technique for the surgical treatment of benign prostate hyperplasia. We believe the results obtained are promising and that they could signify some advantages as opposed to HoLEP. However, prospective randomized studies are required to confirm this opinion.

Keywords:
Benign prostate hyperplasia
Surgery
Prostate Enucleation
Morcellation
Diode laser
DiLEP
Resumen
Introducción

Se presenta la experiencia preliminar y resultados de practicar la técnica de enucleación prostática mediante láser diodo (Dilep) y morcelación intravesical, siguiendo los mismos principios de la enucleación con láser de Holmio (Holep).

Material y método

A lo largo de 5 meses se ha llevado a cabo el tratamiento endoscópico de la hiperplasia benigna de próstata mediante Dilep en 17 pacientes. Todos ellos han sido seguidos tres meses con flujometría e IPSS. Se describe con detalle la técnica de enucleación prostática y de morcelación, así como el material necesario para llevarla a cabo. Se comentan también las enseñanzas aprendidas con la práctica de más de 300 casos con Holep, de cara a la aplicación de esta nueva tecnología.

Resultados

La edad media fue 74,2 años y el volumen prostático medio 61,26 (47–110) cc. La pérdida media de hemoglobina fue 2,1 (1,4–3,1) g/dl. No sucedieron secuelas ni complicaciones mayores. Todos los pacientes abandonaron el hospital a las 24 horas de la intervención. La mejoría en el IPSS (22,3±4,1 vs. 7,1±1,06) y en el Qmax (7,14±2,6 vs. 21,4±3,6) fue ostensible.

Conclusiones

Se trata de la primera descripción de la técnica Dilep para el tratamiento quirúrgico de la hiperplasia benigna de próstata. Pensamos que los resultados conseguidos son prometedores y que podría suponer algunas ventajas frente a Holep. No obstante, se necesitan estudios prospectivos aleatorizados que confirmen esta opinión.

Palabras clave:
Hiperplasia prostática benigna
Cirugía
Enucleación prostática
Morcelación
Láser diodo
Dilep

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