Amy Krambeck Archives

Amy Krambeck

Morcellation and Potential HoLEP Complications

Posted by Amy Krambeck, MD | Nov 2024

Amy E. Krambeck, MD, presents a detailed overview of morcellation and its potential complications, particularly in Holmium Laser Enucleation of the Prostate (HoLEP). In this 14-minute presentation, she explains the technical requirements for performing morcellation.

Dr. Krambeck narrates a video of the procedure’s steps. She highlights how challenging nodules can sometimes require additional laser grooves to enable effective morcellation.

Complications during morcellation are also reviewed. Intraoperative issues include capsular perforations and bladder injuries. Injury to the ureteral orifices, while rare, can occur during morcellation. Dr. Krambeck also discusses postoperative complications and their management, including bleeding, clot retention, and infections such as UTIs or epididymitis. Incontinence, mainly urge incontinence, is another common postoperative issue. However, with proper technique, HoLEP and morcellation present low complication rates and excellent patient outcomes.

Overview of Current Surgical BPH

Posted by Amy Krambeck, MD | Aug 2024

Amy Krambeck, MD, provides a comprehensive overview of current surgical options for treating benign prostatic hyperplasia (BPH), focusing on their efficacy, safety, and practical application. Her analysis emphasizes the evolution of surgical techniques and the criteria for selecting the most appropriate intervention for each patient.

Dr. Krambeck begins by discussing transurethral resection of the prostate (TURP), noting its potential complications, such as bleeding, infection, and the risk of TUR syndrome, which necessitates careful patient selection and postoperative monitoring. She then explores newer surgical techniques as alternatives to TURP, among these, laser therapies such as holmium laser enucleation of the prostate (HoLEP) and photoselective vaporization of the prostate (PVP). Dr. Krambeck also addresses minimally invasive surgical options like prostatic urethral lift (PUL) and water vapor thermal therapy.

The discussion includes a review of the practical considerations for each surgical option, including patient factors such as prostate size, comorbidities, and symptom severity. Complications and postoperative care are also discussed.