Skip to main content

Advertisement

SpringerLink
Log in

Recent evidence for anatomic endoscopic enucleation of the prostate (AEEP) in patients with benign prostatic obstruction on antiplatelet or anticoagulant therapy

  • Invited Review
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Introduction

Due to demographic changes in today's society, the number of patients with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) is increasing. Similarly, the proportion of patients with cardiovascular risk factors undergoing antiplatelet (AP) or anticoagulation (AC) therapy is growing as well.

Methods

This review discusses the current literature on various techniques used for anatomic endoscopic enucleation of the prostate (AEEP) in patients on AC/AP therapy.

Results

The large number of energy sources used for AEEP makes it difficult to compare them. Overall, fewer bleeding-associated complications arise in patients under AP compared to AC or bridging therapy with low molecular weight heparin. However, perioperatively both AP and AC therapy lead to a higher risk of bleeding complications compared to patients not taking anticoagulants.

Conclusions

The literature shows that AEEP is possible and efficacious in patients under AC/AP therapy, with only slight differences compared to patients not taking AC/AP drugs, on a short and long-term basis. Nevertheless, the sparse data, the retrospective nature of many studies and the inclusion of prostate sizes between 50 and 110 ml only, make it difficult to come to strong conclusions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Fraundorfer MR, Gilling PJ (1998) Holmium:YAG laser enucleation of the prostate combined with mechanical morcellation: preliminary results. Eur Urol 33:69–72. https://doi.org/10.1159/000019535

    Article  CAS  PubMed  Google Scholar 

  2. Cornu JN, Ahyai S, Bachmann A, de la Rosette J, Gilling P, Gratzke C, McVary K, Novara G, Woo H, Madersbacher S (2015) A systematic review and meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic obstruction: an update. Eur Urol 67:1066–1096. https://doi.org/10.1016/j.eururo.2014.06.017 (Epub 2014 Jun 25)

    Article  PubMed  Google Scholar 

  3. Gravas S, Bach T, Bachmann A, Drake M, Gacci M, Gratzke C, Madersbacher S, Mamoulakis S, Tikkinen KAO (2016) Guidelines on the management of non-neurogenic male lower urinary tract symptoms (LUTS), incl. benign prostatic obstruction (BPO) EAU; http://uroweb.org/guideline/treatment-of-non-neurogenicmale-luts/. Accessed Mar 2016

  4. Naspro R, Gomez Sancha F, Manica M, Meneghini A, Ahyai S, Aho T, Fiori C, Vavassori I, DA Pozzo LF, Pansadoro V, Montorsi F, Herrmann TR (2017) From “gold standard” resection to reproducible “future standard” endoscopic enucleation of the prostate: what we know about anatomical enucleation. Minerva Urol Nefrol. 69:446–458. https://doi.org/10.23736/S0393-2249.17.02834-X

    Article  PubMed  Google Scholar 

  5. Netsch C, Stoehrer M, Brüning M, Gabuev A, Bach T, Herrmann TR, Gross AJ (2014) Safety and effectiveness of Thulium VapoEnucleation of the prostate (ThuVEP) in patients on anticoagulant therapy. World J Urol 32:165–172. https://doi.org/10.1007/s00345-013-1093-4 (Epub 2013 May 9)

    Article  CAS  PubMed  Google Scholar 

  6. Zhou Y, Boudreau DM, Freedman AN (2014) Trends in the use of aspirin and nonsteroidal anti-inflammatory drugs in the general U.S. population. Pharmacoepidemiol Drug Saf 23:43–50. https://doi.org/10.1002/pds.3463

    Article  CAS  PubMed  Google Scholar 

  7. Daels FP, Gaizauskas A, Rioja J, Varshney AK, Erkan E, Ozgok Y, Melekos M, de la Rosette JJ (2015) Age-related prevalence of diabetes mellitus, cardiovascular disease and anticoagulation therapy use in a urolithiasis population and their effect on outcomes: the clinical research office of the endourological society ureteroscopy global study. World J Urol 33(6):859–864. https://doi.org/10.1007/s00345-014-1382-6 (Epub 2014 Aug 26)

    Article  CAS  PubMed  Google Scholar 

  8. Naspro R, Lerner LB, Rossini R, Manica M, Woo HH, Calopedos RJ, Cracco CM, Scoffone CM, Herrmann TR, de la Rosette JJ, Cornu JN, Pozzo DA, LF, (2018) Perioperative antithrombotic therapy in patients undergoing endoscopic urologic surgery: where do we stand with current literature? Minerva Urol Nefrol 70:126–136. https://doi.org/10.23736/S0393-2249.17.03072-7 (Epub 2017)

    Article  PubMed  Google Scholar 

  9. Hochreiter WW, Thalmann GN, Burkhard FC, Studer UE (2002) Holmium laser enucleation of the prostate combined with electrocautery resection: the mushroom technique. J Urol 168:1470–1474. https://doi.org/10.1097/01.ju.0000025336.31206.25

    Article  PubMed  Google Scholar 

  10. Elzayat E, Habib E, Elhilali M (2006) Holmium laser enucleation of the prostate in patients on anticoagulant therapy or with bleeding disorders. J Urol 175:1428–1432. https://doi.org/10.1016/S0022-5347(05)00645-2

    Article  CAS  PubMed  Google Scholar 

  11. Tyson MD, Lerner LB (2009) Safety of holmium laser enucleation of the prostate in anticoagulated patients. J Endourol 23:1343–1346. https://doi.org/10.1089/end.2009.0013

    Article  PubMed  Google Scholar 

  12. Bishop CV, Liddell H, Ischia J, Paul E, Appu S, Frydenberg M, Pham T (2013) Holmium laser enucleation of the prostate: comparison of immediate postoperative outcomes in patients with and without antithrombotic therapy. Curr Urol 7:28–33. https://doi.org/10.1159/000343549 (Epub 2013 Jul 28)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. El Tayeb MM, Jacob JM, Bhojani N, Bammerlin E, Lingeman JE (2016) Holmium laser enucleation of the prostate in patients requiring anticoagulation. J Endourol 30:805–809. https://doi.org/10.1089/end.2016.0070 (Epub 2016 May 3)

    Article  PubMed  Google Scholar 

  14. Peyronnet B, Robert G, Comat V, Rouprêt M, Gomez-Sancha F, Cornu JN, Misrai V (2017) Learning curves and perioperative outcomes after endoscopic enucleation of the prostate: a comparison between GreenLight 532-nm and holmium lasers. World J Urol 35:973–983. https://doi.org/10.1007/s00345-016-1957-5 (Epub 2016 Oct 20)

    Article  PubMed  Google Scholar 

  15. Sun J, Shi A, Tong Z, Xue W (2018) Safety and feasibility study of holmium laser enucleation of the prostate (HOLEP) on patients receiving dual antiplatelet therapy (DAPT). World J Urol 36:271–276. https://doi.org/10.1007/s00345-017-2129-y (Epub 2017 Nov 14)

    Article  PubMed  Google Scholar 

  16. Romero-Otero J, García-González L, García-Gómez B, Justo-Quintas J, García-Rojo E, González-Padilla DA, Sopeña-Sutil R, Duarte-Ojeda JM, Rodríguez-Antolín A (2019) Factors influencing intraoperative blood loss in patients undergoing holmium laser enucleation of the prostate (holep) for benign prostatic hyperplasia: a large multicenter analysis. Urology 132:177–182. https://doi.org/10.1016/j.urology.2019.06.024 (Epub 2019 Jun 26)

    Article  PubMed  Google Scholar 

  17. Becker B, Netsch C, Hansen J, Böhme A, Gross AJ, Zacharias M, Lehrich K (2019) Perioperative safety in patient under oral anticoagulation during holmium laser enucleation of the prostate. J Endourol 33:219–224. https://doi.org/10.1089/end.2018.0693 (Epub 2019 Jan 8)

    Article  PubMed  Google Scholar 

  18. Boeri L, Capogrosso P, Ventimiglia E, Fontana M, Sampogna G, Zanetti SP, Pozzi E, Zuabi R, Schifano N, Chierigo F, Longo F, Gadda F, Dell’Orto PG, Scattoni V, Montorsi F, Montanari E, Salonia A (2020) Clinical comparison of holmium laser enucleation of the prostate and bipolar transurethral enucleation of the prostate in patients under either anticoagulation or antiplatelet therapy. Eur Urol Focus 6:720–728. https://doi.org/10.1016/j.euf.2019.03.002 (Epub 2019 Mar 11)

    Article  PubMed  Google Scholar 

  19. Deuker M, Rührup J, Karakiewicz PI, Welte M, Kluth LA, Banek S, Roos FC, Mandel P, Chun FK, Becker A (2020) Holmium laser enucleation of the prostate: efficacy, safety and preoperative management in patients presenting with anticoagulation therapy. World J Urol. https://doi.org/10.1007/s00345-020-03272-2

    Article  PubMed  PubMed Central  Google Scholar 

  20. Habib EI, ElSheemy MS, Hossam A, Morsy S, Hussein HA, Abdelaziz AY, Abdelazim MS, Fathy H (2020) Holmium laser enucleation versus bipolar plasmakinetic resection for management of lower urinary tract symptoms in patients with large-volume benign prostatic hyperplasia: randomized-controlled trial. J Endourol. https://doi.org/10.1089/end.2020.0636

    Article  PubMed  Google Scholar 

  21. Westhofen T, Schott M, Keller P, Tamalunas A, Stief C, Magistro G (2020) Superiority of HoLEP over TURP in a matched-pair analysis of bleeding complications under various antithrombotic regimens. J Endourol. https://doi.org/10.1089/end.2020.0321 (PMID: 32940051)

    Article  Google Scholar 

  22. Yuk HD, Oh SJ (2020) Perioperative safety and efficacy of holmium laser enucleation of the prostate in patients receiving antithrombotic therapy: a prospective cohort study. Sci Rep 10:5308. https://doi.org/10.1038/s41598-020-61940-0

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Gild P, Lenke L, Pompe RS, Vetterlein MW, Ludwig TA, Soave A, Chun F, Ahyai SA, Dahlem R, Fisch M, Rink M, Meyer C, Becker A (2020) Assessing the outcome of holmium laser enucleation of the prostate (HoLEP) by age, prostate volume, and a history of blood thinning agents - report from a single-center series of >1,800 consecutive cases. J Endourol. https://doi.org/10.1089/end.2020.0605

    Article  Google Scholar 

  24. Herrmann TRW, Gravas S, de la Rosette JJ, Wolters M, Anastasiadis AG, Giannakis I (2020) Lasers in transurethral enucleation of the prostate-do we really need them. J Clin Med 9:1412. https://doi.org/10.3390/jcm9051412

    Article  PubMed Central  Google Scholar 

  25. Tuccio A, Sessa F, Campi R, Grosso AA, Viola L, Muto G, Scoffone C, Cracco CM, Gómez-Sancha F, Misrai V, Muto G, Mari A, Di Maida F, Tellini R, Figueiredo F, Carini M, Oriti R, Amparore D, Fiori C, Porpiglia F, Minervini A (2020) En-bloc endoscopic enucleation of the prostate: a systematic review of the literature. Minerva Urol Nefrol. 72:292–312. https://doi.org/10.23736/S0393-2249.20.03706-6 (Epub 2020 Jan 30)

    Article  PubMed  Google Scholar 

  26. Bach T, Wendt-Nordahl G, Michel MS, Herrmann TR, Gross AJ (2009) Feasibility and efficacy of Thulium:YAG laser enucleation (VapoEnucleation) of the prostate. World J Urol 27:541–545. https://doi.org/10.1007/s00345-008-0370-0 (Epub 2009 Jan 28)

    Article  CAS  PubMed  Google Scholar 

  27. Hauser S, Rogenhofer S, Ellinger J, Strunk T, Müller SC, Fechner G (2012) Thulium Laser (Revolix) vapoenucleation of the prostate is a safe procedure in patients with an increased risk of hemorrhage. Urol Int 88:390–394. https://doi.org/10.1159/000336874 (Epub 2012 May 23)

    Article  PubMed  Google Scholar 

  28. Netsch C, Magno C, Butticè S, Macchione L, Mucciardi G, Herrmann TR, Gross AJ (2016) Thulium vaporesection of the prostate and thulium vapoenucleation of the prostate in patients on oral anticoagulants: a retrospective three-centre matched-paired comparison. Urol Int 96:421–426. https://doi.org/10.1159/000441013 (Epub 2015 Oct 20)

    Article  CAS  PubMed  Google Scholar 

  29. Bach T, Wölbling F, Gross AJ, Netsch C, Tauber S, Pottek T, Wülfing C, Brunken C (2016) Prospective assessment of perioperative course in 2648 patients after surgical treatment of benign prostatic obstruction. World J Urol 35:285–292. https://doi.org/10.1007/s00345-016-1866-7 (Epub 2016 Jun 4)

    Article  PubMed  Google Scholar 

  30. Castellani D, Di Rosa M, Gasparri L, Pucci M, Dellabella M (2020) Thulium laser vapoenucleation of the prostate (ThuVEP) in men at high cardiovascular risk and on antithrombotic therapy: a single-center experience. J Clin Med 2020(9):917. https://doi.org/10.3390/jcm9040917

    Article  CAS  Google Scholar 

  31. Herrmann TR, Bach T, Imkamp F, Georgiou A, Burchardt M, Oelke M, Gross AJ (2010) Thulium laser enucleation of the prostate (ThuLEP): transurethral anatomicalprostatectomy with laser support. Introduction of a novel technique for the treatment of benign prostatic obstruction. World J Urol 28:45–51. https://doi.org/10.1007/s00345-009-0503-0

    Article  PubMed  Google Scholar 

  32. Castellani D, Pirola GM, Gasparri L, Pucci M, Di Rosa M, Carcano G, Saredi G, Dellabella M (2019) Are outcomes of thulium laser enucleation of the prostate different in men aged 75 and over? a propensity score analysis. Urology 132:170–176. https://doi.org/10.1016/j.urology.2019.06.025 (Epub 2019 Jun 26)

    Article  PubMed  Google Scholar 

  33. Vartak KP, Raghuvanshi K (2019) Outcome of thulium laser enucleation of prostate surgery in high-risk patients with benign prostatic hyperplasia. Urol Ann 11:358–362. https://doi.org/10.4103/UA.UA_175_18

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Buisan O, Saladie JM, Ruiz JM, Bernal S, Bayona S, Ibarz L (2011) Diode laser enucleation of the prostate (Dilep): technique and initial results. Actas Urol Esp. 35:37–41. https://doi.org/10.1016/j.acuro.2010.08.003 (Epub 2011 Jan 5)

    Article  CAS  PubMed  Google Scholar 

  35. Lusuardi L, Mitterberger M, Hruby S, Kunit T, Kloss B, Engelhardt PF, Sieberer M, Janetschek G (2015) Update on the use of diode laser in the management of benign prostate obstruction in 2014. World J Urol 33:555–562. https://doi.org/10.1007/s00345-014-1327-0 (Epub 2014 May 24)

    Article  PubMed  Google Scholar 

  36. Zhang J, Wang X, Zhang Y, Shi C, Tu M, Shi G (2019) 1470 nm Diode laser enucleation vs plasmakinetic resection of the prostate for benign prostatic hyperplasia: a randomized study. J Endourol 33:211–217. https://doi.org/10.1089/end.2018.0499 (Epub 2019 Jan 9)

    Article  PubMed  PubMed Central  Google Scholar 

  37. Zhang J, Li J, Wang X, Shi C, Tu M, Shi G (2020) Efficacy and safety of 1470-nm diode laser enucleation of the prostate in individuals with benign prostatic hyperplasia continuously administered oral anticoagulants or antiplatelet drugs. Urology 138:129–133. https://doi.org/10.1016/j.urology.2020.01.008 (Epub 2020 Jan 21)

    Article  PubMed  Google Scholar 

  38. Goméz Sancha F (2010) GreenLEP, GreenLight laser enucleation of the prostate. Eur Urol Suppl 9(2):344

    Article  Google Scholar 

  39. Misrai V, Cornu J, Bruguiere E, Bordier B, Guillotreau J (2014) Enucléation « en bloc » de la prostate au laser greenlight « GreenLEP ». Prog Urol 24:899. https://doi.org/10.1016/j.purol.2014.09.025

    Article  CAS  PubMed  Google Scholar 

  40. Misrai V, Cornu J, Bruguiere E, Bordier B, Rouprêt M, Guillotreau J (2014) Énucléation prostatique « en bloc » au laser Greenlight (Greenlep): étude de faisabilité technique et résultats fonctionnels préliminaires. Prog Urol 24:881. https://doi.org/10.1016/j.purol.2014.08.211

    Article  CAS  PubMed  Google Scholar 

  41. Gomez Sancha F, Rivera VC, Georgiev G, Botsevski A, Kotsev J, Herrmann T (2015) Common trend: move to enucleation-Is there a case for GreenLight enucleation? Development and description of the technique. World J Urol 33:539–547. https://doi.org/10.1007/s00345-014-1339-9

    Article  PubMed  Google Scholar 

  42. Misrai V, Kerever S, Phe V, Zorn KC, Peyronnet B, Rouprêt M (2016) Direct comparison of GreenLight Laser XPS Photoselective Prostate Vaporization and GreenLight Laser En Bloc Enucleation of the prostate in enlarged glands greater than 80 ml: a study of 120 patients. J Urol 195:1027–1032. https://doi.org/10.1016/j.juro.2015.10.080 (Epub 2015 Oct 17)

    Article  PubMed  Google Scholar 

  43. Misraï V, Pasquie M, Bordier B, Elman B, Lhez JM, Guillotreau J, Zorn K (2018) Comparison between open simple prostatectomy and green laser enucleation of the prostate for treating large benign prostatic hyperplasia: a single-centre experience. World J Urol 36:793–799. https://doi.org/10.1007/s00345-018-2192-z (Epub 2018 Jan 25)

    Article  PubMed  Google Scholar 

  44. Elshal AM, Elkoushy MA, El-Nahas AR, Shoma AM, Nabeeh A, Carrier S, Elhilali MM (2015) GreenLightTM laser (XPS) photoselective vapo-enucleation versus holmium laser enucleation of the prostate for the treatment of symptomatic benign prostatic hyperplasia: a randomized controlled study. J Urol 193:927–934. https://doi.org/10.1016/j.juro.2014.09.097 (Epub 2014 Sep 28)

    Article  PubMed  Google Scholar 

  45. Neill MG, Gilling PJ, Kennett KM, Frampton CM, Westenberg AM, Fraundorfer MR, Wilson LC (2006) Randomized trial comparing holmium laser enucleation of prostate with plasmakinetic enucleation of prostate for treatment of benign prostatichyperplasia. Urology 68:1020–1024. https://doi.org/10.1016/j.urology.2006.06.021 (PMID: 17095078)

    Article  PubMed  Google Scholar 

  46. El-Shaer W, Abou-Taleb A, Kandeel W (2017) Transurethral bipolar plasmakinetic vapo-enucleation of the prostate: Is it safe for patients on chronic oral anticoagulants and/or platelet aggregation inhibitors? Arab J Urol. 15:347–354. https://doi.org/10.1016/j.aju.2017.09.005 (eCollection 2017 Dec)

    Article  PubMed  PubMed Central  Google Scholar 

  47. Hiraoka Y (1983) A new method of prostatectomy, transurethral detach- ment and resection of benign prostatic hyperplasia. Nihon Ika Daigaku Zasshi 50:896–898

    Article  CAS  Google Scholar 

  48. Hiraoka Y, Akimoto M (1989) Transurethral enucleation of benign prostatic hyperplasia. J Urol 142:1247–1250. https://doi.org/10.1016/s0022-5347(17)39047-x

    Article  CAS  PubMed  Google Scholar 

  49. Lusuardi L, Myatt A, Sieberer M, Jeschke S, Zimmermann R, Janetschek G (2011) Safety and efficacy of Eraser laser enucleation of the prostate: preliminary report. J Urol 186:1967–1971. https://doi.org/10.1016/j.juro.2011.07.026 (Epub 2011 Sep 23)

    Article  PubMed  Google Scholar 

  50. Hruby S, Sieberer M, Schätz T, Jones N, Zimmermann R, Janetschek G, Lusuardi L (2013) Eraser laser enucleation of the prostate: technique and results. Eur Urol 63:341–346. https://doi.org/10.1016/j.eururo.2012.08.049 (Epub 2012 Aug 29)

    Article  PubMed  Google Scholar 

  51. Lusuardi L, Hruby S, Janetschek G, Mitterberger M, Sieberer M, Colleselli D, Kunit T, Hitzl W, Kloss B (2015) Laparoscopic adenomectomy versus Eraser laser enucleation of the prostate. World J Urol 33:691–696. https://doi.org/10.1007/s00345-014-1476-1 (Epub 2015 Jan 3)

    Article  CAS  PubMed  Google Scholar 

  52. Enikeev D, Glybochko P, Rapoport L, Gahan J, Gazimiev M, Spivak L, Enikeev M, Taratkin M (2018) A randomized trial comparing the learning curve of 3 endoscopic enucleation techniques (HoLEP, ThuFLEP, and MEP) for BPH using mentoring approach-initial results. Urology 121:51–57. https://doi.org/10.1016/j.urology.2018.06.045 (Epub 2018 Jul 24)

    Article  PubMed  Google Scholar 

  53. Large T, Nottingham C, Stoughton C, Williams J Jr, Krambeck A (2020) Comparative study of holmium laser enucleation of the prostate with MOSES enabled pulsed laser modulation. Urology 136:196–201. https://doi.org/10.1016/j.urology.2019.11.029 (Epub 2019 Nov 30)

    Article  PubMed  Google Scholar 

  54. Hussein Y, Petrelli F, Ceresoli F (2020) HoLEP VS MoLEP, first prospective randomized trial on 140 patients. J Urol 203:e1190

    Article  Google Scholar 

  55. Rodríguez Socarrás M, Fernández Del Álamo J, Gómez Rivas J, Gómez Sancha F (2020) En bloc MoLEP (MOSES HoLEP) with early apical dissection and preservation of the sphincter’s mucosa. Surgical technique and technology developments that allow a new paradigm of endoscopic prostate enucleation. Arch Esp Urol 73:689–698

    PubMed  Google Scholar 

Download references

Funding

We did not receive any funding for our work. Benedikt Becker certifies that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (eg, employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), are the following: None.

Author information

Authors and Affiliations

  1. Department of Urology, Asklepios Hospital Barmbek, Rübenkamp 220, 22291, Hamburg, Germany

    C. Netsch, A. J. Gross & B. Becker

  2. Department of Urology, Urologische Klinik Spital Thurgau, Kantonsspital Frauenfeld, Frauenfeld, Switzerland

    T. R. W. Herrmann

  3. Department of Urology, ASST Valle Olona, Ospedale Di Busto Arsizio (VA), Busto Arsizio, Italy

    G. Bozzini & L. Berti

Authors
  1. C. Netsch
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. R. W. Herrmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G. Bozzini
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. L. Berti
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. J. Gross
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. B. Becker
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Benedikt Becker had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Becker: Project development, Data collection, Data analysis, Manuscript writing/editing. Herrmann: Manuscript writing/editing. Bozzini: Manuscript writing/editing. Berti: Manuscript writing/editing. Gross: Project development, Manuscript writing/editing. Netsch: Project development, Data collection, Data analysis, Manuscript writing/editing.

Corresponding author

Correspondence to C. Netsch.

Ethics declarations

Conflict of interest

Our research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The authors report no conflict of interest.

Ethics approval

This is a review article, ethical approval is therefore not relevant.

Human and animal rights

Neither human participants nor animals were involved in this study.

Informed consent

Informed consent is not relevant in a review article.

Availability of data and material

The data is available for requests.

Code availability

Not applicable.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Netsch, C., Herrmann, T.R.W., Bozzini, G. et al. Recent evidence for anatomic endoscopic enucleation of the prostate (AEEP) in patients with benign prostatic obstruction on antiplatelet or anticoagulant therapy. World J Urol 39, 3187–3196 (2021). https://doi.org/10.1007/s00345-021-03647-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-021-03647-z

Keywords

Search

Navigation