title: Holmium laser enucleation versus transurethral resection of the prostate. Are histological findings comparable?
abstract: OBJECTIVE
  We investigated if an adequate histological diagnosis can be made from tissue after holmium laser enucleation of the prostate (HoLEP) and whether it is comparable to transurethral prostate resection (TURP) tissue findings in patients with benign prostatic hyperplasia.
  
  
  METHODS
  We analyzed 40 HoLEP and 40 age matched TURP tissue specimens from patients who underwent 1 of the 2 procedures between January 2001 and August 2002. Each histological specimen was reviewed by a single pathologist. Preoperative prostate ultrasound volume, total serum prostatic specific antigen and postoperative tissue weight were evaluated. Microscopic histological diagnosis was assessed by standard histological techniques and immunohistochemical evaluation.
  
  
  RESULTS
  Patients were comparable in terms of age and preoperative total serum prostate specific antigen. Tissue remaining following the procedure was estimated to be 36.3% of preoperative ultrasound volume after HoLEP and 52.8% after TURP (p <0.001). Incidental adenocarcinoma and high grade PIN of the prostate were diagnosed in a comparable percent of specimens in the 2 groups. Tissue thermal artifacts induced by the laser were mostly due to coagulation. Thus, the alterations were similar to those after TURP.
  
  
  CONCLUSIONS
  Tissue quality is altered after HoLEP and TURP. General prostatic architecture was maintained in the majority of HoLEP histological specimens. A moderately higher percent of prostatic tissue obtained by the Ho laser is lost by vaporization and coagulation. Nevertheless, these differences do not seem to alter pathologist ability to detect incidental prostate cancer and PIN.
authors.affiliation: Departments of Urology and Pathology, University Vita-Salute San Raffaele, Milan, Italy.
authors.forename: Richard
authors.initials: R
authors.lastname: Naspro
authors.forename: Massimo
authors.initials: M
authors.lastname: Freschi
authors.forename: Andrea
authors.initials: A
authors.lastname: Salonia
authors.forename: Giorgio
authors.initials: G
authors.lastname: Guazzoni
authors.forename: Valerio
authors.initials: V
authors.lastname: Girolamo
authors.forename: Renzo
authors.initials: R
authors.lastname: Colombo
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Scattoni
authors.forename: Patrizio
authors.initials: P
authors.lastname: Rigatti
authors.forename: Francesco
authors.initials: F
authors.lastname: Montorsi
mesh_terms: D006695:Holmium; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D020728:Transurethral Resection of Prostate / Q000379:methods*
chemical_list: D006695:Holmium