Jiwoong Yu1, Byong Chang Jeong1, Seong Soo Jeon1, Sung Won Lee1, Kyu-Sung Lee1,2. 1. Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 2. Department of Medical Device Management and Research, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University School of Medicine, Seoul, Korea.
Abstract
Purpose: We compared success rates of three surgical techniques [holmium laser enucleation of the prostate (HoLEP), transurethral resection of the prostate (TURP), and photoselective laser vaporization prostatectomy (PVP)] for treatment of benign prostatic obstruction (BPO). We aimed to identify preoperative clinical variables and urodynamic parameters that predict surgical success. Methods: A total of 483 patients who underwent surgical treatment for BPO at Samsung Medical Center between 2006 and 2017 were retrospectively analyzed; of these 361, 81, and 41 patients underwent HoLEP, TURP, and PVP, respectively. Prostate-specific antigen, prostate volume, urodynamic parameters, and International Prostate Symptom Score (I-PSS)/quality of life (QoL) index were evaluated preoperatively; uroflowmetry, post-void residual urine, and I-PSS/QoL index were measured six months postoperatively. Surgical success was defined based on I-PSS, maximum flow rate (Qmax), and QoL index and predictive factors were identified using multiple logistic regression analyses. Results: Success rates of HoLEP, TURP, and PVP were 67.6%, 65.4%, and 34.1%, respectively, and the HoLEP and TURP groups were not significantly different. Regression analysis revealed prostate volume ≥ 50 cc and bladder outlet obstruction index (BOOI) ≥ 40 to be independent factors predicting HoLEP success. Only high preoperative QoL could predict the success of TURP, whereas other urodynamic parameters remained unrelated. Conclusions: Patients treated with HoLEP and TURP displayed equivalent efficacies, but PVP was relatively less efficient than both. Preoperative variables of prostate volume ≥ 50 cc and BOOI ≥ 40 were independent predictive factors for the success of HoLEP but not of TURP.
Purpose: We compared success rates of three surgical techniques [holmium laser enucleation of the prostate (HoLEP), transurethral resection of the prostate (TURP), and photoselective laser vaporization prostatectomy (PVP)] for treatment of benign prostatic obstruction (BPO). We aimed to identify preoperative clinical variables and urodynamic parameters that predict surgical success. Methods: A total of 483 patients who underwent surgical treatment for BPO at Samsung Medical Center between 2006 and 2017 were retrospectively analyzed; of these 361, 81, and 41 patients underwent HoLEP, TURP, and PVP, respectively. Prostate-specific antigen, prostate volume, urodynamic parameters, and International Prostate Symptom Score (I-PSS)/quality of life (QoL) index were evaluated preoperatively; uroflowmetry, post-void residual urine, and I-PSS/QoL index were measured six months postoperatively. Surgical success was defined based on I-PSS, maximum flow rate (Qmax), and QoL index and predictive factors were identified using multiple logistic regression analyses. Results: Success rates of HoLEP, TURP, and PVP were 67.6%, 65.4%, and 34.1%, respectively, and the HoLEP and TURP groups were not significantly different. Regression analysis revealed prostate volume ≥ 50 cc and bladder outlet obstruction index (BOOI) ≥ 40 to be independent factors predicting HoLEP success. Only high preoperative QoL could predict the success of TURP, whereas other urodynamic parameters remained unrelated. Conclusions: Patients treated with HoLEP and TURP displayed equivalent efficacies, but PVP was relatively less efficient than both. Preoperative variables of prostate volume ≥ 50 cc and BOOI ≥ 40 were independent predictive factors for the success of HoLEP but not of TURP.
Authors: Mehmet Yilmaz; Mustafa Karaaslan; Halil Cagri Aybal; Maximilian Ferry von Bargen; Senol Tonyali; Tuncay Toprak; Christian Gratzke; Arkadiusz Miernik Journal: Ann Med Surg (Lond) Date: 2022-07-31