4th Annual Jefferson Urology Symposium: Focus on Urinary Incontinence

© The Canadian Journal of Urology TM : International Supplement, August 2021 15 Morcellation can be challenging at times. In situations where it is difficult to collect the tissue pieces via themorcellator (i.e. the “beach-ball” effect, the tissue bounces off the morcellator caused by an indurated nodular adenoma), the RPM of the morcellator is reduced and the adenoma is carried to the prostatic fossa. In this reduced space of the prostatic capsule and decreasedmorcellator blade speed, the ability to remove difficult adenoma pieces is optimized. Extraction devices such as a basket-grasping device introduced through the nephroscope (a device normally used for nephrolithotomy), or a retrieval loop used with a 26Fr resectoscope bridge can drag large indurated pieces out of the urethra. Conclusions HoLEP is an AUA guideline endorsed surgical treatment for LUTS due to BPH, independent of prostate size. 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