title: Evaluation of holmium laser for transurethral deroofing of severe and multiloculated prostatic abscesses.
abstract: OBJECTIVE
  Our objective was to evaluate the use of a holmium laser for transurethral deroofing of a prostatic abscess in patients with severe and multiloculated prostatic abscesses.
  
  
  METHODS
  From January 2011 to April 2014, eight patients who were diagnosed with prostatic abscesses and who underwent transurethral holmium laser deroofing at Pusan National University Hospital were retrospectively reviewed.
  
  
  RESULTS
  Multiloculated or multifocal abscess cavities were found on the preoperative computed tomography (CT) scan in all eight patients. All patients who underwent transurethral holmium laser deroofing of a prostatic abscess had successful outcomes, without the need for secondary surgery. Of the eight patients, seven underwent holmium laser enucleation of the prostate (HoLEP) for the removal of residual adenoma. Markedly reduced multiloculated abscess cavities were found in the follow-up CT in all patients. No prostatic abscess recurrence was found. Transient stress urinary incontinence was observed in three patients. The stress urinary incontinence subsided within 3 weeks in two patients and improved with conservative management within 2 months in the remaining patient.
  
  
  CONCLUSIONS
  Transurethral holmium laser deroofing of prostatic abscesses ensures successful drainage of the entire abscess cavity. Because we resolved the predisposing conditions of prostatic abscess, such as bladder outlet obstruction and prostatic calcification, by simultaneously conducting HoLEP, there was no recurrence of the prostatic abscesses after surgery. We recommend our method in patients requiring transurethral drainage.
authors: Department of Urology, Pusan National University School of Medicine, Busan, Korea.
authors: Chan Ho
authors: CH
authors: Lee
authors: Department of Urology, Pusan National University School of Medicine, Busan, Korea.
authors: Ja Yoon
authors: JY
authors: Ku
authors: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors: Young Joo
authors: YJ
authors: Park
authors: Department of Urology, Pusan National University School of Medicine, Busan, Korea.
authors: Jeong Zoo
authors: JZ
authors: Lee
authors: Department of Urology, Pusan National University School of Medicine, Busan, Korea.
authors: Dong Gil
authors: DG
authors: Shin
mesh_terms: D000038:Abscess / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000150:complications / Q000601:surgery; D004322:Drainage / Q000379:methods; D006695:Holmium; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011469:Prostatic Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D020728:Transurethral Resection of Prostate / Q000379:methods*; D016896:Treatment Outcome; D001748:Urinary Bladder Neck Obstruction / Q000150:complications / Q000601:surgery
chemical_list: D006695:Holmium
keywords: Abscess; Holmium; Prostate; Transurethral resection of prostate