Improving Holmium Laser Enucleation of the Prostate Efficiency: the Lumenis Pulse 120h Laser Platform

Objectives: Benign prostatic hyperplasia (BPH) affects approximately 50% of men over the age of 50 and 88% of men in their 80s, often leading to a decrease in quality of life and ultimately requiring treatment. Holmium laser enucleation of the prostate (HoLEP) has been suggested as the gold standard for surgical treatment for BPH. Multiple technological advances have been made over the last several years to improve the efficacy and efficiency of the procedure including the recent delivery of a new Lumenis Pulse 120H laser platform. The new platform allows for preset energy modes and a dual pedal footswitch to allow the surgeon to switch between two laser settings easily. Typically, lower energy settings are used for hemostasis and near the prostatic apex, compared to higher energy settings used for the majority of the enucleation. Theoretically, the dual foot pedal should allow the enucleation portion of the procedure to proceed more efficiently. The dual foot pedal should also allow for better hemostasis during the case secondary to ease of switching the laser to hemostatic settings with a quick switch using the foot pedal instead using a required laser trained technician to input the settings. This study compares the enucleation efficiency of HoLEP performed with the new Lumenis Pulse 120H laser platform with the older Lumenis 100 Watt VersaPulse.