Meta-analysis of holmium laser enucleation versus transurethral resection of prostate for patients with benign prostatic obstruction

O. Naser, A. Negida, E. Kasem, A. Mokhtar, A. Menshawy, T. Badawy, A.S. Turky, A. Tammam, A. El-Sawaf, B. Gana
2015 International Journal of Surgery  
The aim of this study was to evaluate if Hexaminolevulinate (Hexvix) fluorescence cystoscopy improved bladder tumour identification and management and whether repeated episodes of Hexvix incurred further benefits. Methods: All patients undergoing Hexvix cystoscopy at a District General Hospital between October 2008 and October 2014 were incorporated. Data collected and analysed included reason for Hexvix, repeats of Hexvix, findings at white-light and Hexvix cystoscopies, complications,
more » ... y and outcomes. Results: Sixty cases of Hexvix cystoscopies were performed on forty-nine patients. Nine had repeats and two had a further third episode. No complications were reported. Reasons for Hexvix included thirty-eight (63%) for surveillance/abnormal flexible cystoscopy, ten (16.7%) post-BCG treatment and ten (16.7%) persistently abnormal urine cytology. Twentytwo (36.7%) confirmed bladder carcinoma. Twenty-two cases documented white-light and Hexvix findings. Twelve described no abnormalities with white-light which fluoresced using Hexvix. Of these, five confirmed malignancy. Three of nine patients confirmed bladder malignancies after the initial Hexvix. Subsequent repeats detected no abnormalities. Conclusion: Hexvix improved the detection of bladder tumours, particularly in CIS/pT1G3 tumours. It highlighted areas of malignancies not visualised by white-light cystoscopy. No additional benefits were seen from repeating Hexvix cystoscopies.
doi:10.1016/j.ijsu.2015.07.595 fatcat:qx57ceudhrbovcuqoq7xu56d5y