Medizinische Universität Graz - Research portal
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SHR Neuro Cancer Cardio Lipid Metab Microb
Gild, P; Lenke, L; Pompe, RS; Vetterlein, MW; Ludwig, TA; Soave, A; Chun, FK; Ahyai, S; Dahlem, R; Fisch, M; Rink, M; Meyer, CP; Becker, A.
Assessing the Outcome of Holmium Laser Enucleation of the Prostate by Age, Prostate Volume, and a History of Blood Thinning Agents: Report from a Single-Center Series of >1800 Consecutive Cases.
J Endourol. 2021; 35(5): 639-646.
Doi: 10.1089/end.2020.0605
Web of Science
PubMed
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- Co-authors Med Uni Graz
- Ahyai Sascha
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- Abstract:
- Purpose: To assess perioperative outcomes of holmium laser enucleation of the prostate (HoLEP) in a real-world scenario and with a focus on demanding patient factors, such as large prostate size, advanced patient age, and anticoagulation therapy (AT). Materials and Methods: We retrospectively analyzed HoLEP procedures at our institution between 2010 and 2016. After stratification by prostate volume, age, and AT, perioperative and early voiding characteristics were compared. A multivariable regression model was employed to identify predictors of prolonged time of catheterization (defined as being above group's median). Results: The study cohort consisted of 1816 men with a median age of 71 years (interquartile range [IQR]: 66-76), a median prostate volume of 80 mL (IQR: 58-105), and American Society of Anesthesiologists score ≥3 in 618 men (34%). Median time of enucleation and morcellation was 43 minutes (IQR: 31-60) and 10 minutes (IQR: 6-18), respectively. Perioperative blood transfusions were administered in 44 (2.4%) cases, severe postoperative complications (Clavien-Dindo grade ≥3b) occurred in 61 (3.3%) cases. The median time of catheterization was 2 days (IQR: 2-2), with prolonged catheterization occurring in 277 (15%) cases. After adjustment, large prostates (fourth volume quartile [106-280 mL]) (odds ratio [OR]: 1.8, 95% confidence interval [CI]: 1.3-2.6, p = 0.001), therapeutic low-molecular-weight heparin bridging regimen (OR: 2.2, 95% CI: 1.4-3.6, p = 0.037), low-dose acetylsalicylic acid (OR: 1.5, 95% CI: 1.0-2.2, p = 0.015), and a history of direct oral anticoagulation (OR: 2.3, 95% CI: 1.2-4.0, p = 0.022), but not patient age, were independently associated with prolonged catheterization. Conclusions: We confirm HoLEP as safe and efficient; however, patients with large prostates and patients with a history of AT are at risk of prolonged catheterization.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged - administration & dosage
- Holmium - administration & dosage
- Humans - administration & dosage
- Laser Therapy - administration & dosage
- Lasers, Solid-State - therapeutic use
- Male - administration & dosage
- Prostatic Hyperplasia - surgery
- Retrospective Studies - administration & dosage
- Transurethral Resection of Prostate - administration & dosage
- Treatment Outcome - administration & dosage
- Find related publications in this database (Keywords)
- laser therapy
- lower urinary tract symptoms
- prostatic hyperplasia
- transurethral procedures