The novel HoLEP technique Omega Sign improves continence outcomes of surgery

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madman

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Introduction & Objectives: Holmium-laser enucleation of the prostate (HoLEP) has been a promising surgery of the prostate since its first introduction. Although there are 10 different HoLEP techniques in the literature, stress UI 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, could provide better continence outcomes and decrease SUI rate.

Materials & Methods: After Ethical Committee approval has been obtained, the data of 400 patients who underwent HoLEP by a single surgeon between May 2016-February 2019 were retrospectively reviewed. The patients were divided into two groups, the first underwent the Gilling’s technique (Group 1; n=200) and the second the novel ‘’Omega Sign’’ technique (Group 2; n=200). Continence status and post-micturition symptoms (PMS) were evaluated according to the standards recommended by the international continence status (ICS).

Results: The data of 400 HoLEP procedures between May 2016 and February 2019 were analyzed, comparing Group 1 (n=200) and Group 2 (n=200). Stress urinary incontinence (SUI) rate was significantly lower in Group 2 on the day of catheter removal and 1 st month (p<0.005). Also, urge urinary incontinence (UUI) rate and PMS were significantly lower in Group 2 (Table 1) (Figure 1).

Conclusions: We found better continence results comparable functional outcomes and equally minimal complications as compared to standard HoLEP technique. We believe that the novel ‘Omega sign’ technique decreases SUI rate and will become standardized and easy to understand, thereby bringing and creating a shorter learning curve.
 
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madman

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Table 1: Continence status of patients in the postoperative period
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madman

Super Moderator
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Figure 1:Observation of the Omega Sign formed by the preserved mucosa.
Figure 1a: retrograde view of surgical loge from the urethra,
Figure 1b: Antegrade view of surgical loge from the bladder.
 
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