Objective: Recently, holmium laser enucleation of the prostate (HoLEP) has been established as one method of endoscopic surgery for the treatment of benign prostate hyperplasia (BPH). The purpose of our study was to assess initial clinical experiences with HoLEP at our hospital.;Patients and Methods: A retrospective analysis was conducted of 28 patients with obstructive symptoms due to BPH who underwent HoLEP during the 13 months between February 2004 and March 2005.;Results: The mean age of the patients was 67.4 years (range 59 to 78 years). The mean enucleation tissue weight was 24.3 g (range 2 to 95 g), and the average operation time was 94.1 minutes (range 40 to 268 minutes). The mean duration of postoperative catheterization was 3.4 days (range 1 to 6 days). The mean urine flow rate improved, and each patient's satisfaction for voiding, measured on a 5-point scale, was good. There were no major complications during the operations except one case, which was completed with TUR-P because of uncontrollable bleeding. No patients required transfusions. Long-term complications included five cases of stress incontinence (19%), four of urethral stricture (14%), and three temporary retention, two of which required re-catheterization (10%).;Conclusion: HoLEP can be performed without major intraoperative complications. It is an effective treatment for obstructive symptoms due to BPH. However, there are many postoperative problems that must be resolved, including stress incontinence and urethral stricture because of our lack of experience, with HoLEP.
Enucleation ; Prostatic Hypertrophy, Benign ; Complications Specific to Antepartum or Postpartum ; Lasers ; Holmium

Background: We evaluated the effectiveness of gemcitabine and paclitaxel therapy in patients with metastatic urothelial carcinoma for whom two lines of sequential chemotherapy had been unsuccessful.

Methods: A total number of 105 patients who had previously received first-line chemotherapy consisting of gemcitabine and cisplatin or carboplatin, were treated with second-line gemcitabine and docetaxel therapy between June 2006 and May 2015. Of these patients, 15 with an Eastern Cooperative Oncology Group Performance Status of 0 or 1 were administered gemcitabine and paclitaxel as third-line treatment from 2013 after failure of the second-line therapy. For each 21-day cycle, gemcitabine (1000 mg/m²) was administered on days 1, 8, and 15, and paclitaxel (200 mg/m²) on day 1. Patients were assessed for each cycle and any adverse events were noted. Furthermore, a Short Form Health Survey questionnaire was used to assess each patient’s quality of life.

Results: Third-line gemcitabine and paclitaxel treatment cycles were undertaken for a median of four times (range 2–9). The disease control rate was 80.0%. After second-line gemcitabine and docetaxel therapy was completed, median progression-free survival and median overall survival were determined as 9.8 and 13.0 months, respectively. The only prognostic factor for overall survival, as determined by univariate and multivariate analyses, was third-line gemcitabine and paclitaxel therapy. Neutropenia (66.7%) and thrombocytopenia (53.3%) were noted as the grade 3 treatment-related toxicities. After two cycles of third-line gemcitabine and paclitaxel therapy, the pre- and post-treatment quality of life scores did not differ significantly.

Conclusions: Results demonstrate that third-line combination therapy using gemcitabine and paclitaxel is a feasible option for metastatic urothelial carcinoma patients.