Comparison Study of Learning Curve Using Cumulative Sum Analysis Between Holmium Laser Enucleation of the Prostate and Transurethral Resection of the Prostate: Is Holmium Laser Enucleation of the Prostate a Difficult Procedure for Beginner Urologists?
- Authors
- Kim, Ki Hong; Yang, Hee Jo; Heo, Nam Hun; Kim, Si Hyun; Kim, Doo Sang; Lee, Chang Ho; Jeon, Youn Soo
- Issue Date
- 1-Feb-2021
- Publisher
- Mary Ann Liebert Inc.
- Keywords
- benign prostate hyperplasia; holmium laser enucleation of the prostate; transurethral resection of prostate; learning curve
- Citation
- Journal of Endourology, v.35, no.2, pp 159 - 164
- Pages
- 6
- Journal Title
- Journal of Endourology
- Volume
- 35
- Number
- 2
- Start Page
- 159
- End Page
- 164
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/2037
- DOI
- 10.1089/end.2020.0492
- ISSN
- 0892-7790
1557-900X
- Abstract
- Objectives: Although there is no comparison study about the learning curves for holmium laser enucleation and other surgical modalities to treat benign prostatic hyperplasia (BPH), beginner urologists are hesitant to perform holmium laser enucleation because of its steep learning curve. Therefore, we investigated the degree of surgical difficulty of holmium laser enucleation by comparing its learning curve with that of transurethral resection. Patients and Methods: Two beginner urologists performed surgery for BPH: H.J.Y. performed holmium laser enucleation and K.H.K. performed transurethral resection. Of 141 patients, 72 were enrolled in the holmium laser enucleation group and 69 in the transurethral prostate resection group. After retrospectively reviewing medical records, we performed a cumulative sum analysis of resection speed (RS) and resected ratio (RR) to compare the learning curves of holmium laser enucleation and transurethral resection. Results: Both surgeons achieved RS competency with a speed <0.13 g/min. The surgeon who performed holmium laser enucleation achieved RR competency with a ratio <0.40, whereas the surgeon who performed transurethral resection achieved competency with a ratio <0.35. To achieve RS competency of 0.13 g/mL, the holmium laser enucleation and transurethral resection groups required 12 and 23 cases, respectively. To achieve RR competency of 0.35, the holmium laser enucleation and transurethral resection groups required 12 and 5 cases, respectively. Conclusions: Holmium laser enucleation is not a difficult procedure compared with transurethral resection in beginner urologists. Therefore, it is unnecessary to avoid holmium laser enucleation because the concerns that it may be difficult are unfounded.
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Collections - College of Medicine > Department fo Urology > 1. Journal Articles
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