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Postoperative transient stress urine leakage following Holmium laser enucleation of the prostate is one of the problems that frustrate both surgeon and patients
Standard HoLEP might be associated with some stretch of the sphincter and de-epithelization of the sphincter area anteriorly.
In Veil preserving HoLEP, early separation of the adenoma from the sphincter ring minimizes sphincter stretch. Furthermore, more proximal incision of the 12 O'clock mucosal strip sparring a veil of mucosa covering the sphincter ring.
Our hypothesis is that by this technique the early postoperative transient urine leak would be minimized and duration of leakage if anny would be shortened.
Postoperative transient stress urine leakage following Holmium laser enucleation of the prostate is one of the problems that frustrate both surgeon and patients.
Many reports addressed different variables for the cause of post HoLEP urine leakage. Looking for a procedure done by a single surgeon who had tremendous experience of this procedure may enable investigators to identify precisely technical points of interest that may affect post HoLEP stress urine incontinence.
Standard HoLEP might be associated with some stretch of the sphincter and de-epithelization of the sphincter area anteriorly.
In Veil preserving HoLEP, early separation of the adenoma from the sphincter ring minimizes sphincter stretch. Furthermore, more proximal incision of the 12 O'clock mucosal strip sparring a veil of mucosa covering the sphincter ring.
Investigators' hypothesis is that by this technique the early postoperative transient urine leak would be minimized and duration of leakage if any would be shortened.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Veil sparring HoLEP | Active Comparator | Early mucosal incision lateral to the Veru followed by early separation of the adenoma from the sphincter ring after identification of the plane of enucleation, this minimizes sphincter stretch. Furthermore, more proximal incision of the 12 O'clock mucosal strip sparring a veil of mucosa covering the sphincter ring. |
|
| Standard HoLEP | Active Comparator | Standard HoLEP TECHNIQUE as described by Elhilali et al 2010 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Veil sparring HoLEP | Procedure | Early mucosal incision; lateral to the Veru and proximal to the apical bulge of the adenoma, followed by early separation of the adenoma from the sphincter ring after identification of the plane of enucleation, this minimizes sphincter stretch. Furthermore, more proximal incision of the 12 O'clock mucosal strip sparring a veil of mucosa covering the sphincter ring. |
| Measure | Description | Time Frame |
|---|---|---|
| urine incontinence | one hour pad test for post prostatectomy incontinence, scale from 0 to 4, the higher the more incontinence | 1 month postoperative |
| Measure | Description | Time Frame |
|---|---|---|
| international prostate symptom score | Symptoms core assessment, score from 0 to 35, the higher the worse the urinary symptoms | 1 year |
| urine flow rate | rate of urine flow per unit time, how many milliliters of urine passed per second, above 15ml/second is normal |
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Inclusion Criteria:
Exclusion criteria:
Patients who have any of the following were excluded:
prostate surgeries
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| Name | Affiliation | Role |
|---|---|---|
| Ahmed Elshal | Mansoura University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Urology and nephrology center | Al Mansurah | DK | 35516 | Egypt |
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| Standard HoLEP | Procedure | Holmium laser enucleation of the prostate in the standard approach described by Elhilali et al 2010 |
|
| 1 year |
| urine incontinence | one hour pad test for post prostatectomy incontinence, scale from 0 to 4, the higher the more incontinence | 4 months postoperative |
| International Consultation on Incontinence Questionnaire Short-Form | Continence core assessment, score from 0 to 21, the higher the worse the urinary continence | one month postoperative |