Difficulty in the intravesical morcellation procedure for leiomyoma of the prostate enucleated by HoLEP

Toshiaki Shinojima, Shunsuke Yoshimine

Research output: Contribution to journalArticle

Abstract

Leiomyoma of prostate are rare benign neoplasms that are usually diagnosed incidentally through postoperative pathological examination. A 70-year-old man is presented with severe symptoms of lower urinary tract obstruction. Although a digital rectal examination and the prostate-specific antigen level did not suggest malignancy, transrectal ultrasonography showed an unusual homogenous echoic mass measuring 45×37 mm in size in the prostate. A needle biopsy was performed and pathological diagnosis was prostatic leiomyoma. Holmium laser enucleation of prostate (HoLEP) was chosen and performed to resect the tumour. Although the enucleation step presented no problems, the morcellation procedure using a conventional transurethral mechanical morcellator was very difficult owing to the firmness of the tissue. By using a bipolar erectrosurgical loop, fragmentation and removal of tissue was accomplished. This is the first case reported of these rare neoplasms in which HoLEP was offered as a less invasive surgical approach. We emphasise the firmness of the leiomyomatous tissue, which would lead to morcellation failure.

Original languageEnglish
Article number200200
JournalBMJ Case Reports
DOIs
Publication statusPublished - 2013 Aug 21
Externally publishedYes

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Solid-State Lasers
Leiomyoma
Prostate
Neoplasms
Digital Rectal Examination
Lower Urinary Tract Symptoms
Needle Biopsy
Prostate-Specific Antigen
Ultrasonography
Morcellation

ASJC Scopus subject areas

  • Medicine(all)

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Difficulty in the intravesical morcellation procedure for leiomyoma of the prostate enucleated by HoLEP. / Shinojima, Toshiaki; Yoshimine, Shunsuke.

In: BMJ Case Reports, 21.08.2013.

Research output: Contribution to journalArticle

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