Concordance among experts in assessing apical mucosal preservation during holmium laser enucleation of the prostate (HoLEP): implications for artificial intelligence model development - Takeaways - MDSpire

Concordance among experts in assessing apical mucosal preservation during holmium laser enucleation of the prostate (HoLEP): implications for artificial intelligence model development

  • By

  • Archan Khandekar

  • Aravindh Rathinam

  • Ansh Bhatia

  • Diana M. Lopategui

  • Jonathan Katz

  • Roger L. Sur

  • Nicholas Smith

  • Pankaj N. Maheshwari

  • Hemendra N. Shah

  • December 4, 2025

  • 0 min

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  • 1

    Holmium laser enucleation of the prostate (HoLEP) is effective for benign prostatic hyperplasia but can lead to transient stress urinary incontinence.

  • 2

    Technical modifications in HoLEP, such as improved mucosal preservation techniques, have reduced postoperative incontinence rates significantly.

  • 3

    Evaluating expert concordance in assessing apical mucosal preservation is essential for developing AI models to predict postoperative outcomes.

  • 4

    Six urologists independently rated apical mucosal preservation in HoLEP videos, using a three-tiered scale to classify preservation levels.

  • 5

    Statistical analyses, including Cohen’s Kappa, were used to evaluate interrater reliability and correlation between mucosal ratings and continence outcomes.

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