Jonas Herrmann

Assoc. Prof. of Urology | head of urologic laser center at AVK Berlin | endourology & HoLEP enthusiast | husband and proud dad of 3 | views my own

[Jonas Herrmann @JnsHerrmann]

@GuidoGiusti @RebecaEscobarM @OlympusMedEMEA Well done, Guido, interesting case and perfect demonstration as usual 👍

[Jonas Herrmann @JnsHerrmann]

I want to share a gift i got today from a happy patient with artistic talent 😊. Posted with permisson. (Translation: the wonder of HoLEP, before and after)

[Jonas Herrmann @JnsHerrmann]

I need to chose a system for lithotripsy in PCNL beside lasers for very large stones and staghorn stones. Efficiency is what i am looking for. In your experience: which one should i chose and why? @sbinhamrii @VicentiniUro @GuidoGiusti @UrologoEdgar @MartinCKanne @DrVCMohan

[Jonas Herrmann @JnsHerrmann]

@AustenSlade Great video! Beautiful technique and clear explanations 👍

[Shahrokh F. Shariat @DrShariat]

Comparing the Performance of Digital Rectal Examination and Prostate-specific Antigen as a Screening Test for Prostate Cancer: A Systematic Review and Meta-analysis - European Urology Oncology https://t.co/svZ9owxpHL

[Jonas Herrmann @JnsHerrmann]

Delighted and honored to join the EAU Section of Endourolgy led by @OTRAXER as an associate member of the Prostate Group led by @trwherrmann. 🙏🙏🙏

[Jonas Herrmann @JnsHerrmann]

@EricLiUro @amy_krambeck @NM_Urology Good publication. This is helpful 👍

[Eric Li @EricLiUro]

🚨New Publication🚨

-12.8% iPCa, 4.4% >GG2 (n=811)
-PHI >55 associated with iPCa
-Pre op PIRADS 4-5, neg biopsy with 95% NPV for iPCa
-Most iPCa is low volume GG1 managed with active surveillance, n=3 further PCa treatment

https://t.co/UZfAPpARlJ

@amy_krambeck @NM_Urology

[Jonas Herrmann @JnsHerrmann]

@mahmoudlaimon @lfredosanchez @fgomsan @Dmitry_Enikeev @DocGauhar @drabhaymahajan @RRGonzalezMD @KarinLehrich In those very large glands it is common not to reach the bladder in the beginning. Usually you can reach the bladder ventrally at 12 ' in enbloc technique. Perineostomy is the last ressort if that fails (happened to me only once, Patient was obese and had a 300g gland)

[Jonas Herrmann @JnsHerrmann]

We finished the month of july with 91 HoLEP procedures. Thanks to all my team and keep up the good work! 🙏🙏🙏 Blessed to be at #ULZB at #AVKBerlin

[Jonas Herrmann @JnsHerrmann]

@Dmitry_Enikeev @MUN_journal @AndreyOMorozov @vs_petov @E_Laukhtina @jteoh_hk @nirmishsingla @trwherrmann @DrShariat Nice! Unfortunately i dont have access to the full text. Did you fragment or morcellate the larger tumors?

[Jonas Herrmann @JnsHerrmann]

@TFL_URO_APIS @wjurol I think resection has not been the gold standard for many years. The reference standard at best. Read the study. After 100 cases the average OR time was 54 min for 90g prostate. No transfusions in 500 cases, clavien grade 3b in 1,4%. This is not possible with resection IMO.

[Jonas Herrmann @JnsHerrmann]

Mastering HoLEP is challenging initially, but how long do we keep improving after the initial learning curve? Our recent single-surgeon series published in @wjurol shows no plateau even after 500 cases. https://t.co/TNEkZsd1TV

[Jonas Herrmann @JnsHerrmann]

@FCAFigueiredo @uroledezma @wjurol Thank you 🙏 Staying humble and striving to improve is definately part of it, but i believe HoLEP is a unique surgery with a lot of intangible skills that take a long time to develop. I find this fascinating and i dont see it in other procedures, even compex ones.

[Jonas Herrmann @JnsHerrmann]

@wjurol The good news for beginners: improvments were seen only enucleation efficiency, not functional outcomes or complications. Also, average OR time was below 1 hr after the first 100 cases. You dont need 500 cases to perform a safe holep with good outcome, but you will get faster...

[Jonas Herrmann @JnsHerrmann]

@wroclawski_uro @scoffonecesare @AmerUrological @Uroweb @CAU_URO @sbuoficial @SIU_urology @Endo_Society @docmeetings Risk of incontinence is higher, but not because of HoLEP but in general. I think we unterstimate the risk of long term catheterisation. We see so many geriatric patients with catheter associated infections, that may be lifethreatening.

[Jonas Herrmann @JnsHerrmann]

@wroclawski_uro @AmerUrological @Uroweb @CAU_URO @sbuoficial @SIU_urology @Endo_Society @docmeetings HoLEP that was in case anyone wonders.

[Jonas Herrmann @JnsHerrmann]

@wroclawski_uro @AmerUrological @Uroweb @CAU_URO @sbuoficial @SIU_urology @Endo_Society @docmeetings Funny I just operated a very similar case, 96 years old, no meds, inependent. Does not want to live with catheter. PV Was 80g. Spinal anesthesia, operation took 34 min. Cath until tomorow discharge on friday if all goes smothely.

[Jonas Herrmann @JnsHerrmann]

@AustenSlade @FCAFigueiredo @TheWolfRep This is my experience as well. I stopped doing BNI only of retrograde ejaculation is not an issue. Its a completely different story compared to TUR-P, the risk is so much lower.

[Vivantes Netzwerk für Gesundheit GmbH @Vivantes]

Schonend, blutungsarm, gründlich: Das sind Vorteile einer Holmium-Laser-Enukleation bei einer gutartigen #Prostatavergrößerung. Mehr zur #HoLEP Methode und für wen sie geeignet ist im aktuellen Blog-Interview mit @JnsHerrmann:
https://t.co/dXMaMNczbh