To gain insight from the experience of learning HoLEP, teaching HoLEP, and the current HoLEP practice patterns of fellowship-trained endourologists.
Surveys were electronically distributed to U.
S. practicing urologists who completed American Endourology fellowships (that included HoLEP) within the past 6 years. Questions focused on HoLEP training and current practice patterns.
As of September 2019, 12% (6/49) of U.S. endourology fellowships reported including HoLEP as a component of training. With a 73% response rate (16 of 22), 81% participated in over 20 cases during training, while 50% participated in over 50. 25% independently completed over 50 cases from start to finish. At training completion, most (80%) felt comfortable/somewhat comfortable completing an entire HoLEP independently and managing post-op complications. Seventy-five percent practice HoLEP currently, and 25% teach to trainees. When asked "What is most challenging about HoLEP in current practice?" common responses were: efficiency/profitability concerns, poor reimbursement, educating OR/hospital staff, establishing case volume, minimizing sphincter trauma, and large glands (>200gm).
With diverse exposure in fellowship, most incorporate HoLEP into their practice after training. Aspects of the procedure remain challenging after several years of experience. Profitability/reimbursement concerns should be further explored to increase HoLEP adoption.
Urology. 2021 Jan 04 [Epub ahead of print]
Henry C Wright, Donald Fedrigon, Smita De
Glickman Urological and Kidney Institute, Cleveland Clinic, 9500 Euclid Ave, Q-10 Cleveland, OH, 44195 USA. Electronic address: ., Glickman Urological and Kidney Institute, Cleveland Clinic, 9500 Euclid Ave, Q-10 Cleveland, OH, 44195 USA. Electronic address: ., Glickman Urological and Kidney Institute, Cleveland Clinic, 9500 Euclid Ave, Q-10 Cleveland, OH, 44195 USA. Electronic address: .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/33412221