Presentation Authors: Ki Hong Kim*, Hee Jo Yang, Nam Hun Heo, Si Hyun Kim, Doo Sang Kim, Chang Ho Lee, Youn Soo Jeon, Cheonan, Korea, Republic of
Introduction: Even though there was no comparison study about the learning curve of HoLEP and other surgical modalities to treat low urinary tract symptoms, several beginner urologists have hesitation on performing Holmium laser enucleation of the prostate (HoLEP) because HoLEP had been known to have stiff learning curve. Therefore, we investigated the degree of surgical difficulty of HoLEP by comparing the learning curve of HoLEP and transurethral resection of the prostate (TURP).
Methods: Two young urologists with 2 years fellowship have performed surgical treatment for BPH . HJY performed only HoLEP, and KHK performed only TURP in all cases. From total 141 BPH patients, 72 patients were enrolled to HoLEP group and 69 patients were enrolled to TURP group. After reviewing medical records retrospectively, authors performed the cumulative sum (CUSUM) analysis in retrieval rate (RR) and enucleation ratio (ER) to compare the learning curve of HoLEP and TURP.
Results: In terms of RR, both surgeons achieved competency under 0.13 gm/min. and for ER, the surgeon who performed HoLEP archived competency under 0.40, while TURP group archived competency under 0.35. For achieving competency of â€˜RR = 0.13 gm/mlâ€™, HoLEP group and TURP group required 12 and 23 cases, respectively. For achieving competency of â€˜ER = 0.35â€™, HoLEP group and TURP group required 12 and 5 cases, respectively.
Conclusions: Considering RR and ER, HoLEP is not difficult procedure compared to TURP in beginner urologists. We suggest that it is unnecessary to hesitate on performing HoLEP because of a groundless concern that HoLEP may be difficult procedure .