In vivo Temperature Assessment during Holmium Laser Enucleation of the Prostate

Yilmaz M. · Heuring C.E.M. · Schoeb D. · Suarez-Ibarrola R. · Gratzke C. · Hein S. · Miernik A.

Author affiliations

Department of Urology, Faculty of Medicine, University of Freiburg – Medical Centre, Freiburg, Germany

Log in to MyKarger to check if you already have access to this content.

Buy FullText & PDF Unlimited re-access via MyKarger Unrestricted printing, no saving restrictions for personal use
read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.

Save over 20% compared to the individual article price.

Learn more

Rent via DeepDyve Unlimited fulltext viewing of this article Organize, annotate and mark up articles Printing and downloading restrictions apply

Start free trial

Subscribe Access to all articles of the subscribed year(s) guaranteed for 5 years Unlimited re-access via Subscriber Login or MyKarger Unrestricted printing, no saving restrictions for personal use read more

Subcription rates

Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview

Abstract of Research Article

Received: October 06, 2022
Accepted: December 19, 2022
Published online: March 01, 2023

Number of Print Pages: 7
Number of Figures: 2
Number of Tables: 2

ISSN: 0042-1138 (Print)
eISSN: 1423-0399 (Online)

For additional information: https://www.karger.com/UIN

Abstract

Introduction: Holmium laser enucleation of the prostate (HoLEP) has become popular worldwide for the surgical treatment of benign prostate hyperplasia. Holmium laser is considered an ideal transurethral thermomechanical device for enucleating the prostate. Although there is evidence on Ho:YAG laser-related heat generation, the studies mainly investigated ex vivo temperature generation during holmium laser lithotripsy. In this in vivo study, we aimed to assess for the first time the real-time heat generated during HoLEP. Methods: Fifteen HoLEP procedures were included. The study was conducted over a time period of 16 months. To investigate the temperature generation, a preoperatively inserted rectal temperature probe and a temperature sensor within a suprapubic bladder catheter were used to record the temperature change during enucleation and coagulation. Results: The mean values of the temperature change during the laser enucleation and coagulation were −0.35 ± 0.203 K (IQR: 0.23) and +0.14 ± 0.259 K (IQR: 0.3), respectively, in rectal measurements. Temperature differences during laser use and coagulation were <+1 K and <+5 K, respectively, in bladder measurements. We measured no temperature >37.1°C during the procedures and no temperature values considered harmful to the human body. Conclusion: Sufficient irrigation flow rates and irrigation monitoring during HoLEP are obligatory. To prevent a high and uncontrolled temperature rise, the surgeon or operating room staff should pay attention to the irrigation’s continuity.

© 2023 S. Karger AG, Basel

References Gratzke C, Bachmann A, Descazeaud A, Drake MJ, Madersbacher S, Mamoulakis C, et al. EAU guidelines on the assessment of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. Eur Urol. 2015;67(6):1099–109. Fraundorfer MR, Gilling PJ. Holmium:YAG laser enucleation of the prostate combined with mechanical morcellation: preliminary results. Eur Urol. 1998;33(1):69–72. Rieken M, Ebinger Mundorff N, Bonkat G, Wyler S, Bachmann A. Complications of laser prostatectomy: a review of recent data. World J Urol. 2010 Feb;28(1):53–62. Vincent MW, Gilling PJ. HoLEP has come of age. World J Urol. 2015 Apr;33(4):487–93. Nair SM, Pimentel MA, Gilling PJ. A review of laser treatment for symptomatic BPH (Benign Prostatic Hyperplasia). Curr Urol Rep. 2016 Jun;17(6):45. Porreca A, Colicchia M, Tafuri A, D’Agostino D, Busetto GM, Crestani A, et al. Perioperative outcomes of holmium laser enucleation of the prostate: a systematic review. Urol Int. 2022;106(10):979–91. Uhlig A, Baunacke M, Groeben C, Borkowetz A, Volkmer B, Ahyai SA, et al. [Contemporary surgical management of benign prostatic obstruction in Germany: a population-wide study based on German hospital quality report data from 2006 to 2019]. Urologe A. 2022 May;61(5):508–17. Naspro R, Gomez Sancha F, Manica M, Meneghini A, Ahyai S, Aho T, et al. From “gold standard” resection to reproducible “future standard” endoscopic enucleation of the prostate: what we know about anatomical enucleation. Minerva urol nefrol. 2017 Oct;69(5):446–58. Sapareto SA, Dewey WC. Thermal dose determination in cancer therapy. Int J Radiat Oncol Biol Phys. 1984 Jun;10(6):787–800. Molina WR, Silva IN, Donalisio da Silva R, Gustafson D, Sehrt D, Kim FJ. Influence of saline on temperature profile of laser lithotripsy activation. J Endourol. 2015 Feb;29(2):235–9. Hein S, Petzold R, Schoenthaler M, Wetterauer U, Miernik A. Thermal effects of Ho: YAG laser lithotripsy: real-time evaluation in an in vitro model. World J Urol. 2018 Sep;36(9):1469–75. Maxwell AD, MacConaghy B, Harper JD, Aldoukhi AH, Hall TL, Roberts WW. Simulation of laser lithotripsy-induced heating in the urinary tract. J Endourol. 2019 Feb;33(2):113–9. Miernik A, Schoeb DS. “Three horse shoe-like incision” holmium laser enucleation of the prostate: first experience with a novel en bloc technique for anatomic transurethral prostatectomy. World J Urol. 2019 Mar;37(3):523–8. Thomsen S, Pearce J. Thermal damage and rate processes in biologic tissues; 2011. p. 487–549. Bauer KD, Henle KJ. Arrhenius analysis of heat survival curves from normal and thermotolerant CHO cells. Radiat Res. 1979 May;78(2):251–63. van Rhoon GC, Samaras T, Yarmolenko PS, Dewhirst MW, Neufeld E, Kuster N. CEM43 degrees C thermal dose thresholds: a potential guide for magnetic resonance radiofrequency exposure levels? Eur Radiol. 2013 Aug;23(8):2215–27. Aldoukhi AH, Hall TL, Ghani KR, Maxwell AD, MacConaghy B, Roberts WW. Caliceal fluid temperature during high-power holmium laser lithotripsy in an in vivo porcine model. J Endourol. 2018 Aug;32(8):724–9. Wang XK, Jiang ZQ, Tan J, Yin GM, Huang K. Thermal effect of holmium laser lithotripsy under ureteroscopy. Chin Med J. 2019 Aug 20;132(16):2004–7. Pillai RG, Al Naieb Z, Angamuthu S, Mundackal T. Diode laser vaporisation of the prostate vs. diode laser under cold irrigation: a randomised control trial. Arab J Urol. 2014 Dec;12(4):245–50. Article / Publication Details

First-Page Preview

Abstract of Research Article

Received: October 06, 2022
Accepted: December 19, 2022
Published online: March 01, 2023

Number of Print Pages: 7
Number of Figures: 2
Number of Tables: 2

ISSN: 0042-1138 (Print)
eISSN: 1423-0399 (Online)

For additional information: https://www.karger.com/UIN

Copyright / Drug Dosage / Disclaimer Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

留言 (0)

沒有登入
gif