Dr. Heidenberg on whether HoLEP study data will influence technique

In this video, Daniel J. Heidenberg, MD, discusses whether findings from the recent Urology paper, “The Impact of Standard vs Early Apical Release HoLEP Technique on Postoperative Incontinence and Quality of Life” will affect his clinical practice. Heidenberg is an endourology fellow at Mayo Clinic in Phoenix, Arizona.

Transcription:

Are these findings likely to change your clinical practice in any way?

To tell you the truth, at the very beginning of this, we thought this was going to lead us down the road of a power analysis for a prospective randomized trial. I believe that the more you add as high-level evidence to anything as you can, that's really great and really tries to show the wider community that there's good reason that we're doing something. I know that sometimes people can say, "Retrospective data is not quite as strong as the prospective stuff," which we understand, but I think it was hard for any of us to feel comfortable moving forward with a prospective trial, because we felt the results were so powerful. I don't think anybody, at least in our Mayo Clinic practices, is ever doing anything other than apical release HoLEPs these days. And it also I think, has impacted the way that we consider TURPs. Personally, for me, I don't think I was quite as keen on making sure that when I'm doing swipes apically and anteriorly I was like, I kind of want to get to what I think looks like a nice capsule, do the right thing, the way we were taught in residency, all these things. And now, I think, posteriorly and laterally, you want to be true to that. But anteriorly, if you open up a nice channel, I think, less may be more up there just to try to follow the drawing.

This transcription was edited for clarity.