ArticleWorld journal of urology2025
A practical approach to overcome challenges in morcellation following minimally invasive laser enucleation of the prostate: suprapubic percutaneous transvesical morcellation.
Article 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.
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Who cites it
1 citing paper in PubMed.
- [Democratization of the anatomical endoscopic enucleation of the prostate with bipolar energy].Revista medica del Instituto Mexicano del Seguro Social · 2026Review
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7 authors.
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Abstract
objectiveTo identify the challenges encountered during the morcellation process and to propose an alternative morcellation approach for patients with urethral strictures that preclude transurethral morcellation.
methodsA prospective analysis was conducted on 173 patients who underwent Thulium fiber laser prostate enucleation. Suprapubic percutaneous transvesical morcellation (SPTM) was applied in cases where transurethral morcellation was not feasible.
resultsSixteen patients underwent SPTM, while 157 underwent standard transurethral morcellation. Morcellation times were similar between the SPTM and standard transurethral morcellation groups (p = 0.627). The SPTM group had shorter total operation and enucleation times, smaller prostate volume, lower PSA levels, and reduced morcellation efficiency (p < 0.05). However, hospitalization time was longer, and catheterization time was shorter in the standard group (p < 0.05). Notably, in eighteen patients with unusually tough prostatic tissue, described as a "beach ball," the morcellation phase was significantly more challenging. Patients in the beach ball group undergoing standard transurethral morcellation had longer morcellation times and lower morcellation efficiency compared to those without beach ball (p < 0.05). Additionally, the beach ball group exhibited higher enucleation efficiency, prostate volume, PSA levels, total laser energy values, longer hospitalization, and postoperative catheterization times, as well as prolonged enucleation and total operation times, compared to patients without this condition (p < 0.05). Prostate tissue density, however, did not differ significantly between the two groups (p = 0.071).
conclusionsFor patients in whom transurethral insertion of a morcellator is not feasible, percutaneous suprapubic insertion provides a practical and safe alternative for completing the morcellation process.
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