{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T07:30:39Z","timestamp":1786606239340,"version":"build-2736575974"},"reference-count":43,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Endourology"],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The prevalence of incidental prostate cancer (iPCa) after holmium laser enucleation of the prostate (HoLEP) ranges from 5% to 20%. The hypothesis is that prior HoLEP may complicate the treatment of such cancers with RARP and negatively impact post-RARP functional outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In February 2025, PubMed\u00ae, Scopus\u00ae, and Web of Science\u2122 were assessed to retrieve data of men with PCa undergoing RARP (P) after HoLEP (I), compared to those without prior HoLEP (C). The outcomes of interest included surgical results (O) from retrospective and prospective comparative studies (Studies). Surgical intra- (OT, EBL, number of nerve-sparing RARP and bladder neck reconstruction), and postoperative (LOS, time to catheter removal), pathological (PSM and tumor stage), oncological (BCR), and functional (postoperative continence and sexual function recovery) outcomes were meta-analyzed, using WMD for continuous variables and odd ratio (OR) for dichotomous variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      After study selection, three comparative retrospective studies were included in the SR and MA, comprising 63 patients undergoing RARP after HoLEP and 322 patients who underwent RARP. Compared to patients who underwent RARP without prior HoLEP, patients undergoing RARP after HoLEP had a statistically significantly longer OT (WMD: 31.99 minutes,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001), higher likelihood of bladder neck reconstruction (OR: 9.90,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001), and longer time to catheter removal (WMD: 0.48 days,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.003). However, no differences in terms of pathological, oncological, and functional outcomes were reported between the two groups. The main limitation relates to the inclusion of only three retrospective comparative studies and the small cohort of post-HoLEP patients, which limits the statistical power and generalizability of the findings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Prior HoLEP may introduce certain surgical challenges, reflected in longer OT, a greater need for bladder neck reconstruction, and a longer time to catheter removal. However, these procedural differences do not appear to affect oncological or functional outcomes after RARP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08927790261415936","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T06:04:07Z","timestamp":1769061847000},"page":"488-497","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Prior Holmium Laser Enucleation of the Prostate on Robot-Assisted Radical Prostatectomy Outcomes: A Systematic Review and Meta-Analysis of Comparative Studies"],"prefix":"10.1177","volume":"40","author":[{"given":"Francesco","family":"Ditonno","sequence":"first","affiliation":[{"name":"Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Verona, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"Ronca","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Verona, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greta","family":"Pettenuzzo","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Verona, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Montanaro","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Verona, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Costantino","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Verona, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Malandra","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Verona, Italy."},{"name":"Residency Program in Health Statistics and Biometrics, University of Verona, Verona, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umberto","family":"Carbonara","sequence":"additional","affiliation":[{"name":"Department of Precision and Regenerative Medicine and Ionian Area - Urology, Andrology and Kidney Transplantation Unit, University of Bari \u201cAldo Moro,\u201d Bari, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celeste","family":"Manfredi","sequence":"additional","affiliation":[{"name":"Department of Woman, Child and General and Specialized Surgery, Unit of Urology, University of Campania \u201cLuigi Vanvitelli,\u201d Naples, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Bianchi","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Verona, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Rizzetto","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Verona, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Ferro","sequence":"additional","affiliation":[{"name":"Department of Health Science, ASST Santi Paolo and Carlo, University of Milan, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria 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