Rohit Majumdar1, Hossein S Mirheydar2, Kerrin L Palazzi3, Charles M Lakin2, Michael E Albo2, J Kellogg Parsons4. 1. University of California, San Diego School of Medicine, La Jolla, USA. 2. University of California, San Diego School of Medicine, La Jolla, USA ; Department of Urology, UC San Diego Health System, San Diego, USA. 3. Urologic Cancer, UC San Diego Moores Cancer Center, La Jolla, USA. 4. University of California, San Diego School of Medicine, La Jolla, USA ; Department of Urology, UC San Diego Health System, San Diego, USA ; Urologic Cancer, UC San Diego Moores Cancer Center, La Jolla, USA ; Section of Urology, VA San Diego Healthcare System, San Diego, CA, USA.
Abstract
INTRODUCTION: There are few data on the safety and efficacy of laser photoselective vaporization (LVP) in elderly men. We compared the safety and efficacy of LVP for the treatment of symptomatic benign prostatic hyperplasia (BPH) in men ≥75 years, who we defined as elderly, to those <75 years. MATERIALS AND METHODS: Safety and efficacy outcomes in elderly men undergoing LVP for lower urinary tract symptoms secondary to BPH from 2005 to 2012 were compared with men <75 years. Differences between-groups in demographics, perioperative outcomes, complications, and postoperative changes in International Prostate Symptom Score (I-PSS) were calculated. RESULTS: Of 202 patients, 49 (24%) were elderly (range: 75-95 years) and 153 (76%) were <75 years. Preoperatively, elderly men were more likely to have heart disease (35% vs. 20%, P = 0.03), gross hematuria (6.1% vs. 0.7%, P = 0.05), urinary retention (57% vs. 41%, P = 0.07), and take anti-coagulants (61% vs. 35%, P = 0.002). Elderly men had a longer median length of stay (1 day vs. 0 day, P = 0.001). There were no significant between-group differences in transfusion frequency (4.4% vs. 0.7%, P = 0.14) or Clavien III complications (2% vs. 2.6%, P = 1.0). One month postsurgery, elderly patients reported smaller median decreases in I-PSS (5.5 vs. 9, P = 0.02) and urinary bother (1 point vs. 2, P = 0.03) compared with preoperative values. At till 9 months follow-up, there were no significant between-group differences in median I-PSS or urinary bother scores. CONCLUSIONS: Despite a higher prevalence of preoperative comorbidity and urinary retention, elderly LVP patients experienced perioperative safety and shorter term efficacy outcomes comparable to younger men.
INTRODUCTION: There are few data on the safety and efficacy of laser photoselective vaporization (LVP) in elderly men. We compared the safety and efficacy of LVP for the treatment of symptomatic benign prostatic hyperplasia (BPH) in men ≥75 years, who we defined as elderly, to those <75 years. MATERIALS AND METHODS: Safety and efficacy outcomes in elderly men undergoing LVP for lower urinary tract symptoms secondary to BPH from 2005 to 2012 were compared with men <75 years. Differences between-groups in demographics, perioperative outcomes, complications, and postoperative changes in International Prostate Symptom Score (I-PSS) were calculated. RESULTS: Of 202 patients, 49 (24%) were elderly (range: 75-95 years) and 153 (76%) were <75 years. Preoperatively, elderly men were more likely to have heart disease (35% vs. 20%, P = 0.03), gross hematuria (6.1% vs. 0.7%, P = 0.05), urinary retention (57% vs. 41%, P = 0.07), and take anti-coagulants (61% vs. 35%, P = 0.002). Elderly men had a longer median length of stay (1 day vs. 0 day, P = 0.001). There were no significant between-group differences in transfusion frequency (4.4% vs. 0.7%, P = 0.14) or Clavien III complications (2% vs. 2.6%, P = 1.0). One month postsurgery, elderly patients reported smaller median decreases in I-PSS (5.5 vs. 9, P = 0.02) and urinary bother (1 point vs. 2, P = 0.03) compared with preoperative values. At till 9 months follow-up, there were no significant between-group differences in median I-PSS or urinary bother scores. CONCLUSIONS: Despite a higher prevalence of preoperative comorbidity and urinary retention, elderly LVP patients experienced perioperative safety and shorter term efficacy outcomes comparable to younger men.
Authors: David M Bouchier-Hayes; Paul Anderson; Scott Van Appledorn; Pat Bugeja; Anthony J Costello Journal: J Endourol Date: 2006-08 Impact factor: 2.942
Authors: Alexander Bachmann; Leander Schürch; Robin Ruszat; Stephen F Wyler; Hans-Helge Seifert; Alexander Müller; Kurt Lehmann; Tullio Sulser Journal: Eur Urol Date: 2005-07-18 Impact factor: 20.096
Authors: Robin Ruszat; Stephen F Wyler; Michael Seitz; Kurt Lehmann; Constanze Abe; Gernot Bonkat; Oliver Reich; Thomas C Gasser; Alexander Bachmann Journal: BJU Int Date: 2008-07-29 Impact factor: 5.588
Authors: M Gallucci; P Puppo; M Perachino; P Fortunato; G Muto; G Breda; A Mandressi; G Comeri; C Boccafoschi; F Francesca; S Guazzieri; G L Pappagallo Journal: Eur Urol Date: 1998 Impact factor: 20.096