V02-01 ULTRASOUND-GUIDED MORCELLATION DURING DIFFICULT HOLMIUM LASER ENUCLEATION OF THE PROSTATE (HOLEP)

INTRODUCTION AND OBJECTIVES:Holmium Laser Enucleation of the Prostate (HoLEP) has emerged as a standard of care in the treatment of benign prostatic hyperplasia (BPH). This operation entails two distinct parts - laser enucleation of the adenoma from the surrounding prostatic capsule followed by morcellation of this enucleated prostate from within the distended bladder. HoLEP is associated with a steep learning curve and multiple studies have reported bladder injury sustained during the morcellation portion of the operation as a potential catastrophic complication, occurring in up to 6% of cases. The risk of this complication increases when there is poor intravesical visualization due to either a bloody field or poor optics. The aim of this study is to report the novel use of bladder ultrasound during morcellation to assist with safe completion of HoLEP.METHODS:Enucleation is performed using a 26-French continuous flow scope, off-set laser bridge with a laser stabilization catheter, and a 550μm holmium las...