Does Resectoscope Sheath Size Influence Holmium Laser Enucleation of the Prostate Outcomes? A Prospective Randomized Controlled Trial

• DOI: 10.1089/end.2023.0383
• Publication Date: 2023-10-03T06:47:50Z
• Authors: Nicholas S. Dean; Matthew S. Lee; Mark A. Assmus; Jenny Guo; Perry Xu; Alyssa McDonald; Alla Fadl-Alla; Jessica Helin; Amy E. Krambeck
• Keywords: Barbed suture

Introduction: Holmium laser enucleation of the prostate (HoLEP) is routinely performed with a 24F, 26F, or 28F scope. Proponents larger scopes propose that bigger sheath size allows for superior flow and visibility leading to more efficient operation better hemostasis. Those utilizing smaller suggest less traumatic, resulting in lower stricture rates temporary incontinence. We sought compare outcomes ambulatory HoLEP using 24F Materials Methods: From May 2022 March 2023, we randomized patients undergoing (<200 cm3 size) 1:1 either The primary outcome was differences surgical duration between groups (minutes). Secondary included surgeon scope evaluation postoperative patient results. Results: There no difference characteristics those (n = 76) vs (p > 0.05) scopes. Procedural efficiencies were not different (all p 0.05). associated improved surgeon-graded irrigation < 0.001). Patients treated likely achieve effective same-day trial void (SDTOV) (28F 94.3% 82.1%, 0.048) have shorter length stay (LOS) 7.0 11.9 hours, 0.014), however, discharge (SDD) statistically 87.8% 78.4%, 0.126). cohorts 90-day emergency room presentations, re-admissions, complications, functional ouctomes Conclusions: identified clear advantage regard intraoperative at 3-month follow-up due size. However, if SDD part your pathway, may shorten LOS increase SDTOV. Clinicaltrials.gov: NCT05308017.