The role of preoperative imaging with HoLEP for BPH

In this video, Amy E. Krambeck, MD, shares her perspective on the role of preoperative imaging when performing holmium laser enucleation of the prostate (HoLEP) for the treatment of benign prostatic hyperplasia. Krambeck is a professor of urology at the Northwestern University Feinberg School of Medicine in Chicago, Illinois.

Transcription:

What are your current perspectives on the role of preoperative imaging in planning and optimizing HoLEP procedures?

I think when people are first starting out, imaging is so important. They really need to understand how big the prostate is and how big of a surgery that they're looking at, because a 40-gram HoLEP is an hour or less, and with a 600-gram HoLEP, you're looking at 4 hours. You really need to understand what it is you're doing. I prefer either a non-contrast CT scan or an MRI of the prostate. I think that the non-contrast CT scan is great for sizing. It doesn't require a transrectal probe. It's more comfortable for the patient. I like the MRI if the patient has an elevated PSA or a concern for prostate cancer, because we can do their prostate cancer work-up with the imaging and potentially biopsy off that MRI as well. So get 1 test or the other, and it really depends on their prostate cancer risk, their PSA, and their family history as to which one I get. However, if I have a patient who came in with a transrectal ultrasound from somewhere else, I'll use that imaging too, but I need some type of sizing to know how big the prostate is before the surgery.

This transcription was AI generated and edited by human editors for clarity.