An Improved Morcellation Procedure for Holmium Laser Enucleation of the Prostate

Purpose: We modified the conventional morcellation procedure for holmium laser enucleation of the prostate (HoLEP), and its outcomes are presented in this article. Materials and Methods: As 395 patients were included, the conventional morcellation procedure was performed in the first 100 cases (group 1, cases 1-100), and an improved procedure was used in the last 100 cases (group 2, cases 296-395). The improved morcellation process has three steps to execute. The morcellation time, collected tissue weight, morcellation rate, and associated complications were recorded. Results: The tissue-resected weight was similar between group 1 (60.7 +/- 33.9 g) and group 2 (62.4 +/- 36.8 g). The mean morcellation time in group 1 was greater than that in group 2 (11.3 +/- 7.1 and 8.3 +/- 4.1 minutes, respectively), and the mean morcellation rate was better in group 2 than in group 1 (5.75 +/- 1.7g/minutes in group 1 v 7.3 +/- 1.1 g/minutes in group 2). Complications, such as bladder injury, were similar in both groups. Conclusion: The improved morcellation procedure described in this article can be used in various situations of suction and can be performed in a more fluent manner and with better efficiency.