{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T14:10:20Z","timestamp":1791555020100,"version":"4.3.4"},"reference-count":19,"publisher":"Wiley","issue":"16","license":[{"start":{"date-parts":[[2024,9,8]],"date-time":"2024-09-08T00:00:00Z","timestamp":1725753600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Prostate"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The objective of the present study is to prospectively analyze the prostate enucleation procedure with Holmium Laser using the minimally invasive technique (MiLEP), comparing the outcomes and their variables pre\u2010 and postoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We studied men aged 40 years or over, with prostate volumes greater than or equal to 35\u2009cm\u00b3 with lower urinary tract symptoms due to BPH. We performed flowmetry and administered the IPSS questionnaire before and 6 months after the MiLEP procedure. The patients were operated on with a 60\u2009W Holmium Laser (Cyber\u2010Ho Quanta System\u00ae) using 54\u2009W of power (energy 1.8\u2009J and frequency of 30\u2009Hz). Enucleation was performed using the en bloc technique with early sphincter release. After enucleation, the tissue was morcellated using a 22 Fr morcescope (RZ\u2010Medizintechnik GmbH, Tuttlingen, Germany) and Piranha (Richard Wolf) morcellator. The final Hemostasis after morcelation was made using laser with 30wW power, energy at 1,0 joules and frequency at 30 Hertz. Student's T test and Man\u2010Whitney was used to statistical analysis (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After selection we submitted 73 patients (mean age= 68.2 years) to MiLEP procedure with a follow up of 6 months. The prostate volume presented an average of 94.53\u2009cm\u00b3 (65 to 112\u2009cm\u00b3, SD\u2009=\u20095.363) preoperatively. The urinary continence rate after the procedure was greater than 95% after 1 week and 99% in the 1st month. All patients were continent after 6 months. The IPSS questionnaire before (mean\u2009=\u200921.18 points\/SD\u2009=\u20096.557) and after (mean\u2009=\u20097.92 points\/SD\u2009=\u20092.408) the MiLEP had statistical significance (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The flowmetry(ml\/s) before (9.02\/SD\u2009=\u20092.842) and after (21.07\/SD\u2009=\u20096.228) the MiLEP had statistical significance (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The average time of the procedure was 78.5\u2009min and the bladder catheter was removed after 18\u2009h in mean. In 4 patients (5.8%) we observed hematuria and in 1 case (1.47%) the patient needs urinary catheterization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>MiLEP is a safe and effective procedure, with significant improvement in urinary flow and symptoms in the short term. Although the results of this study were satisfactory and the urinary incontinence rate was lower compared to HoLEP data found in the literature, multicenter studies with longer follow\u2010up are needed to confirm these findings.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pros.24790","type":"journal-article","created":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T04:13:25Z","timestamp":1725855205000},"page":"1501-1505","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Prospective results of the minimally invasive laser enucleation of the prostate (MiLEP)"],"prefix":"10.1002","volume":"84","author":[{"given":"Breno Barros","family":"Alves","sequence":"first","affiliation":[{"name":"Urogenital Research Unit of the Department of Anatomy of State University of Rio de Janeiro \u2013 UERJ Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Gabrich","sequence":"additional","affiliation":[{"name":"Urogenital Research Unit of the Department of Anatomy of State University of Rio de Janeiro \u2013 UERJ Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1562-6068","authenticated-orcid":false,"given":"Luciano A.","family":"Favorito","sequence":"additional","affiliation":[{"name":"Urogenital Research Unit of the Department of Anatomy of State University of Rio de Janeiro \u2013 UERJ Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,8]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"EAU Guidelines.2023.http:\/\/uroweb.org\/guidelines\/compilations-of-all-guidelines\/"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2009.0147"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.21050"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.13124"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/luts.12414"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-023-04562-1"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-019-02671-4"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2010.09954.x"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000000280"},{"key":"e_1_2_10_11_1","doi-asserted-by":"crossref","unstructured":"HarrisE FosterFD TobiasS et al.Surgical Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline Amendment 2019.McVary From the American Urological Association Education and Research Inc.","DOI":"10.1097\/JU.0000000000000319"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2020.04.012"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tvir.2020.100696"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2016.01.138"},{"issue":"4","key":"e_1_2_10_15_1","article-title":"Holmium laser enucleation of the prostate is associated with complications and sequelae even in the hands of an experienced surgeon","volume":"9","author":"Capogrosso P","year":"2023","journal-title":"European Urology Focus"},{"issue":"4","key":"e_1_2_10_16_1","article-title":"Orgasmic function worsening could lead to erectile function decrease after holep \u2013 results from a prospective trial (ExpHo)","volume":"20","author":"Dr. Paolo C","year":"2023","journal-title":"J Sex 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