Department of Urology, Gazi University School of Medicine, Ankara, Turkey.
Department of Urology, Gülhane Training and Research Hospital, Health Sciences University, Ankara, Turkey.
World J Urol. 2021 Jan;39(1):135-141. doi: 10.1007/s00345-020-03152-9. Epub 2020 Mar 19.
Holmium-laser enucleation of the prostate (HoLEP) has been a promising prostate surgery since its first introduction. Although there are 10 different HoLEP techniques in the literature, stress urinary incontinence (SUI) is common, because surgery is not performed based on the topographic anatomy of the external sphincter. We have developed a new HoLEP method named as the ''Omega Sign technique", which is based on the topographic anatomy of the external sphincter and could provide better continence outcomes by decreasing SUI rates.
The data of 400 patients who underwent HoLEP by a single surgeon between May 2016 and February 2019 were retrospectively reviewed. The patients were divided into two groups, the first underwent the Gilling's technique (Group 1) and the second the novel ''Omega Sign'' technique (Group 2). Continence status and post-micturition symptoms (PMS) were evaluated according to the standards recommended by the international continence status.
The data of 400 HoLEP procedures between May 2016 and February 2019 were analyzed, comparing Group 1 (n = 200) and Group 2(n = 200). SUI rate was significantly lower in Group 2 at the day of catheter removal and first month (p < 0.005). In addition, urge urinary incontinence (UUI) rate and PMS were significantly lower in Group 2.
We could demonstrate improved continence results, comparable functional outcomes and equally minimal complications with the standard HoLEP technique. We believe that, the novel 'Omega sign' technique decreases SUI rates and will become standardised and easy to understand, thereby bringing and creating a shorter learning curve.
钬激光前列腺剜除术（HoLEP）自首次引入以来一直是一种很有前途的前列腺手术。尽管文献中有 10 种不同的 HoLEP 技术，但压力性尿失禁（SUI）很常见，因为手术不是根据外括约肌的解剖结构进行的。我们开发了一种新的 HoLEP 方法，命名为“Omega 签名技术”，它基于外括约肌的解剖结构，可以通过降低 SUI 率来提供更好的控尿效果。
回顾性分析了 2016 年 5 月至 2019 年 2 月期间由一名外科医生进行的 400 例 HoLEP 患者的数据。患者分为两组，第一组接受 Gilling 技术（第 1 组），第二组接受新的“Omega 签名”技术（第 2 组）。根据国际控尿状况推荐的标准评估控尿状态和排尿后症状（PMS）。
分析了 2016 年 5 月至 2019 年 2 月期间的 400 例 HoLEP 手术，比较了第 1 组（n=200）和第 2 组（n=200）。第 2 组在拔除导尿管和第一个月时 SUI 发生率明显较低（p<0.005）。此外，第 2 组急迫性尿失禁（UUI）发生率和 PMS 明显较低。
我们可以证明，与标准 HoLEP 技术相比，新的“Omega 签名”技术具有更好的控尿效果、相似的功能结果和同样轻微的并发症。我们相信，新的“Omega 签名”技术降低了 SUI 发生率，将变得标准化和易于理解，从而带来和创造更短的学习曲线。
