{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T10:49:38Z","timestamp":1782730178910,"version":"3.54.5"},"reference-count":14,"publisher":"FapUNIFESP (SciELO)","issue":"4","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Assoc. Med. Bras."],"abstract":"<jats:p>SUMMARY  OBJECTIVE: The aim of this study was to compare the safety and effectiveness of the three-lobe and en-bloc techniques during the learning curve of holmium laser enucleation of the prostate.  METHODS: We conducted a prospective, parallel-group, multicenter study that included patients who underwent holmium laser enucleation of the prostate between February and December 2024 at two tertiary urology departments. Patients with prostate volumes \u226580 cm3 scheduled for holmium laser enucleation of the prostate were alternately assigned (1:1) to either the three-lobe or en-bloc technique. Exclusion criteria included use of anticoagulants, prostate biopsy within the previous month, diagnosis of prostate cancer, or a history of pelvic surgery or radiotherapy associated with overactive bladder symptoms. The study evaluated the performance of a single surgeon at each center using either the three-lobe or en-bloc technique during their holmium laser enucleation of the prostate learning curve. Primary outcomes were enucleation time\/efficiency and complications. Secondary outcomes included postoperative incontinence and functional outcomes.  RESULTS: A total of 116 patients were enrolled in the study, with 60 in the three-lobe group and 56 in the en-bloc group. Patients in the en-bloc group were older than those in the three-lobe group (69.4 vs. 64.9 years, p=0.001). Body mass index and performance scores were comparable between groups. The mean prostate volume was 83.5 cm3 in the three-lobe group and 81.3 cm3 in the en-bloc group (p=0.732). No significant differences were observed in prostate volume or Prostate-Specific Antigen density. Short-term complication rates and postoperative urinary incontinence were similar between techniques. Operative and enucleation times were significantly shorter in the en-bloc group compared to the three-lobe group (86.1 vs. 107.4 min, p=0.042; 56.7 vs. 72.9 min, p=0.001, respectively). However, enucleation and morcellation efficiencies did not differ significantly. Other intraoperative parameters, as well as postoperative functional outcomes and uroflowmetry measurements, were comparable between the groups.  CONCLUSION: The en-bloc technique demonstrated comparable safety and functional outcomes to the three-lobe technique but offered significantly shorter operative and enucleation times during the holmium laser enucleation of the prostate learning curve.<\/jats:p>","DOI":"10.1590\/1806-9282.20252163","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T10:41:51Z","timestamp":1782729711000},"source":"Crossref","is-referenced-by-count":0,"title":["Comparison of three-lobe and en-bloc techniques during the holmium laser enucleation of the prostate learning curve: a prospective, multicenter, cohort study"],"prefix":"10.1590","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0202-0454","authenticated-orcid":false,"given":"Ozgur","family":"Kazan","sequence":"first","affiliation":[{"name":"Istanbul Medeniyet University,  Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0823-7400","authenticated-orcid":false,"given":"Yusuf","family":"Arikan","sequence":"additional","affiliation":[{"name":"University of Health Sciences,  Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1098-4748","authenticated-orcid":false,"given":"Adnan","family":"Basaran","sequence":"additional","affiliation":[{"name":"Istanbul Medeniyet University,  Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9206-5586","authenticated-orcid":false,"given":"Mehmet Zeynel","family":"Keskin","sequence":"additional","affiliation":[{"name":"University of Health Sciences,  Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7029-0109","authenticated-orcid":false,"given":"Burak","family":"T\u00fcfekci","sequence":"additional","affiliation":[{"name":"Istanbul Medeniyet University,  Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0550-250X","authenticated-orcid":false,"given":"Ilkin","family":"Hamid-Zada","sequence":"additional","affiliation":[{"name":"Istanbul Medeniyet University,  Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3386-971X","authenticated-orcid":false,"given":"Asif","family":"Yildirim","sequence":"additional","affiliation":[{"name":"Istanbul Medeniyet University,  Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2026]]},"reference":[{"issue":"8","key":"ref1","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1177\/08927790251360022","article-title":"Mastering HoLEP: learning curves and perioperative complications in holmium laser enucleation of the prostate","volume":"39","author":"Glienke M","year":"2025","journal-title":"J Endourol"},{"issue":"1","key":"ref2","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1007\/s00345-024-05379-2","article-title":"Application trends and research hotspots of endoscopic enucleation of the prostate: a bibliometric and visualization analysis","volume":"43","author":"Lan XD","year":"2025","journal-title":"World J Urol"},{"issue":"1","key":"ref3","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1111\/j.1464-410X.2007.07341.x","article-title":"Holmium laser enucleation of the prostate (HoLEP)","volume":"101","author":"Gilling 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