Complications and Proposed Preventive Measure of Holumium Laser Enucleation of the Prostate during the Initial Phase at Our Hospital
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- Takeuchi Yasuharu
- The Department of Urology, Toho University Ohashi Medical Center
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- Sekido Noritoshi
- The Department of Urology, Toho University Ohashi Medical Center
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- Sawada Yoshitomo
- The Department of Urology, Toho University Ohashi Medical Center
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- Hashimoto Hironori
- The Department of Urology, Toho University Ohashi Medical Center
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- Miyazaki Kouichi
- The Department of Urology, Toho University Ohashi Medical Center
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- Watanabe Kuroudo
- The Department of Urology, Toho University Ohashi Medical Center
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- Watanabe Shoutaro
- The Department of Urology, Toho University Ohashi Medical Center
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- Kinno Kurenai
- The Department of Urology, Toho University Ohashi Medical Center
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- Niitsu Yasuo
- The Department of Urology, Toho University Ohashi Medical Center
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- Endo Fumiyasu
- The Department of Urology, St Luke's International Hospital
Bibliographic Information
- Other Title
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- ホルミウムレーザー前立腺核出術導入期の合併症とその対策に関する検討
- ホルミウムレーザー ゼンリツセンカクシュツジュツ ドウニュウキ ノ ガッペイショウ ト ソノ タイサク ニ カンスル ケントウ
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Abstract
Clinical charts of 95 patients who underwent holmium laser enucleation of the prostate (HoLEP) between May 2012 and January 2016 were reviewed for complications and their causative factors, as well as treatment outcomes. Of 23 intraoperative complications and 3 cases of prolonged post prostatectomy incontinence, 23 incidents (89%) occurred within the initial 20 cases performed by each surgeon. The details of the intraoperative complications were : bladder injury, 6 (6.3%) ; perforation at 6 o’clock beneath the bladder neck, 2 (2.1%) ; capsular perforation, 4 (4.2%) ; and equipment failure, 9 (9.5%). Bladder injury and capsular perforation resulted frompoor hemostasis, while perforation beneath the bladder neck resulted fromforceful retrograde dissection under disorientation. Excessive tension in the external sphincter during retrograde dissection, but not antegrade, could lead to prolonged incontinence. HoLEP improved bladder outlet obstruction subjectively and objectively. During the initial phase of HoLEP, adequate hemostasis and meticulous plane dissection at the bladder neck and antegrade dissection at the apical portions are of paramount importance to prevent significant surgical complications.
Journal
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- 泌尿器科紀要
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泌尿器科紀要 64 (5), 207-212, 2018-05-31
泌尿器科紀要刊行会
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Details 詳細情報について
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- CRID
- 1390572174798342016
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- NII Article ID
- 120006492006
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- NII Book ID
- AN00208315
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- HANDLE
- 2433/233050
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- NDL BIB ID
- 029004522
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- ISSN
- 00181994
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- PubMed
- 30064159
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- Text Lang
- ja
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- Data Source
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- JaLC
- IRDB
- NDL
- PubMed
- CiNii Articles
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- Abstract License Flag
- Allowed