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Erschienen in:

08.07.2023 | Original Article

A Delphi consensus to standardize the technique of anatomical endoscopic enucleation of prostate: a study by ESUT endoscopic enucleation of prostate study group

verfasst von: Lutfi Tunc, Thomas Herrmann, Selcuk Guven, Cesare Marco Scoffone, Giorgio Bozzini, Sercan Yilmaz, Javier Romero-Otero, Vincent Misrai, Angelo Porreca, Sacha Ahyai, Ali Serdar Gozen

Erschienen in: World Journal of Urology | Ausgabe 9/2023

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Abstract

Purpose

Our objective was to establish a standardized technique for Anatomical Endoscopic Enucleation of Prostate (AEEP) utilizing a consensus statement to provide robust recommendations for urologists who are new to this procedure.

Methods

The participants were electronically sent a questionnaire in three consecutive rounds. In the second and third rounds, the anonymous aggregate results of the previous round were presented. Experts’ feedback and comments were then incorporated to refine existing questions or to explore more controversial topics in greater depth.

Results

Forty-one urologists participated in the first round. In the second round, all Round 1 participants received a 22-question survey, resulting in a consensus on 21 items. In the third round, 76% (19/25) of the second-round respondents also participated, reaching a consensus on 22 additional items. The panelists consensually agreed on detaching the urethral sphincter at the beginning of the enucleation and not at the end of the enucleation. To prevent incontinence, it was recommended that the apical mucosa be preserved through various approaches between 11 and 1 o’clock while gently disrupting the lateral lobes in their apical part, avoiding an excess energy delivery approximation to the apical mucosa.

Conclusion

To optimize laser AEEP procedures, urologists must follow expert guidelines on equipment and surgical technique, including early apical release, using the 3-lobe technique for enucleation, preserving apical mucosa with appropriate approaches, gently disrupting lateral lobes at their apical regions, and avoiding excessive energy delivery near the apical mucosa. Following these recommendations can lead to improved outcomes and patient satisfaction.

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Titel: A Delphi consensus to standardize the technique of anatomical endoscopic enucleation of prostate: a study by ESUT endoscopic enucleation of prostate study group
verfasst von: Lutfi Tunc
Thomas Herrmann
Selcuk Guven
Cesare Marco Scoffone
Giorgio Bozzini
Sercan Yilmaz
Javier Romero-Otero
Vincent Misrai
Angelo Porreca
Sacha Ahyai
Ali Serdar Gozen
Publikationsdatum: 08.07.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 9/2023
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-023-04496-8

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A Delphi consensus to standardize the technique of anatomical endoscopic enucleation of prostate: a study by ESUT endoscopic enucleation of prostate study group