Evidence map›Paper›PMID 40848058›Full record

ReviewWorld journal of urology2025

Safety and efficacy of concomitant holmium laser enucleation of the prostate with transurethral endoscopic management of symptomatic large bladder diverticulum: revisiting a historical technique in the modern era with literature review.

Aravindh Rathinam, Ansh Bhatia, Maggie Meyreles, Hasim Bakbak, Johnathan Katz, Robert Marcovich, Hemendra N Shah

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Aravindh RathinamDesai Sethi Urology Institute, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL, 33136, USA.
Ansh BhatiaDepartment of interventional radiology, University of Miami Miller School of Medicine, Miami, FL, USA.
Maggie MeyrelesDesai Sethi Urology Institute, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL, 33136, USA.
Hasim BakbakDesai Sethi Urology Institute, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL, 33136, USA.
Johnathan KatzDesai Sethi Urology Institute, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL, 33136, USA.
Robert MarcovichDesai Sethi Urology Institute, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL, 33136, USA.
Hemendra N ShahDesai Sethi Urology Institute, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL, 33136, USA. drhemendrashah@yahoo.co.in.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAcquired bladder diverticulum (BD) is typically managed using open, laparoscopic, or robotic approaches. Although transurethral techniques demonstrated favorable outcomes in the 1970s and 1980s, they have largely fallen out of favor. This study revisits transurethral endoscopic management of large, symptomatic BD, combined with Holmium laser enucleation of the prostate (HoLEP) for patients with benign prostatic obstruction (BPO) and coexisting BD.

methodsWe retrospectively reviewed patients who underwent combined HoLEP with transurethral endoscopic management of bladder diverticulum (C-HoLEP-TUBD) between May 2017 and January 2025. Following HoLEP, the diverticular neck was circumferentially resected, and the diverticular mucosa was fulgurated using bipolar cautery. Follow-up cystography was obtained 6-12 weeks postoperatively and perioperative data were collected and analyzed.

resultsSix patients (mean age: 72 + 7.46 years) underwent the procedure. The mean prostate volume was 91 ± 43 cc, and mean BD size was 8.57 ± 5.28 cm. Preoperative Qmax averaged 4.76 ml/s, and mean post-void residual (PVR) was 372.8 cc. At 3-month follow-up, Qmax improved to 25.74 ± 22.4 ml/s, and PVR decreased to 22 ± 23.24 cc. Mean diverticulum size reduced to 1.7 ± 1.19 cm, representing an of 81.89 ± 15.09% reduction. No patient had a residual diverticulum > 2 cm or developed related symptoms during follow-up.

conclusionC-HoLEP-TUBD is a safe and effective technique for managing large, symptomatic bladder diverticula in patients with BPO. This combined approach offers significant improvements in urinary function and diverticulum size. Further multi-institutional studies are warranted to confirm these findings and evaluate long-term outcomes.

Indexed as

DiverticulumLasers, Solid-StateLaser TherapyTransurethral Resection of ProstateUrinary Bladder DiseasesAgedAged, 80 and overCystoscopyHumansMaleProstatic HyperplasiaRetrospective StudiesTreatment OutcomeUrinary BladderBladder diverticular ablationBladder diverticulumBladder outlet obstructionBPHDiverticular neck incisionEndoscopic managementHoLEP

Identifiers

PMID40848058
PMCPMC12374890

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.