ArticleInternational urology and nephrology2026
HoLEP for large and mega glands: real-world outcomes and evidence of size-enhanced efficiency.
Article in International urology and nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe term "mega gland" commonly refers to prostates > 200 mL on preoperative imaging. These glands are traditionally perceived as technically challenging for holmium laser enucleation of the prostate (HoLEP) due to increased vascularity, difficult dissection planes, and instrument length limitations. We evaluated perioperative outcomes and procedural efficiency of HoLEP for mega glands compared with large glands (120-200 mL).
methodsWe performed a single-center retrospective analysis of patients undergoing HoLEP for glands ≥ 120 mL between January 2021 and June 2025. Patients were categorized into large (120-200 mL) and mega (> 200 mL) gland groups. Baseline characteristics, intraoperative parameters, efficiency metrics, and postoperative outcomes were compared using Wilcoxon rank-sum, Pearson's Chi square, and Fisher's exact tests.
resultsAmong 602 HoLEPs performed, 243 patients met inclusion criteria, including 208 with large glands and 35 with mega glands. Baseline characteristics were similar, although mega glands had higher PSA values (9.9 vs 5.6 ng/mL, p = 0.001). Operative time was longer in mega glands (114 vs 96 min, p = 0.003). However, enucleation speed (2.8 vs 1.6 g/min, p < 0.001) and energy efficiency (0.8 vs 0.5 g/kJ, p < 0.001) were significantly higher despite similar enucleation times. Postoperative outcomes, including catheter duration, failed void trial, emergency department visits, readmissions, and 3-month PROMs, were similar between groups.
conclusionHoLEP for prostates > 200 mL showed higher enucleation speed and energy efficiency without worse short-term outcomes. These findings suggest HoLEP may be a size-enhanced procedure, not merely size-independent. Further work is needed to define this efficiency threshold more precisely and explore its clinical implications.
Indexed as
Identifiers
42545564What OpenQuestion holds
Registered trials
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.