Aquablation with subsequent selective bipolar cauterization versus holmium laser enucleation of the prostate (HoLEP) with regard to perioperative bleeding.

INTRODUCTION: To compare the surgical methods of Aquablation followed by selective hemostasis by bipolar cauterization with holmium laser enucleation of the prostate (HoLEP) with regard to the risk of perioperative bleeding complications. MATERIALS AND METHODS: A retrospective comparison was carried out on a total of 382 patients who had undergone either Aquablation (n = 167) or HoLEP (n = 215) at our hospital between April 2018 and July 2020. The following were studied: Hb loss, the need for packed red blood cell transfusions and surgical revisions due to bleeding from the prostatic fossa. RESULTS: Transfusions were not necessary in the Aquablation group, while one man who underwent HoLEP had to receive a transfusion. Revision surgery due to bleeding was necessary during the early postoperative course in 13.2% of Aquablations and in 9.8% of HoLEPs (statistically not significant; p = 0.329). The perioperative Hb loss was comparable in both entire collectives (Aquablation 1.37 +/- 1.13 mg/dL, HoLEP 1.22 +/- 1.03 mg/dL; statistically not significant; p = 0.353). For subgroup analysis the groups Aquablation and HoLEP were into three subgroups respectively according to sonographically determined preoperative prostate volume ('small' < 40 mL, 'medium' 41-80 mL, 'large' > 80 mL). There were no significant differences between the subgroups regarding need for transfusions and hematuria-related complications. CONCLUSIONS: The rate of perioperative hematuria related complications of Aquablation with subsequent selective hemostasis equals those found after holmium laser enucleation.

Lycopene for advanced hormone refractory prostate cancer: a prospective, open phase II pilot study.

PURPOSE: We investigated the influence of lycopene on the clinical and laboratory course in men with hormone refractory prostate cancer. To our knowledge this study represents the first time that subjective assessments of the course of therapy have been recorded. MATERIAL AND METHODS: We performed a prospective, open phase II pilot study, in which patients with progressive hormone refractory prostate cancer were included. Lycopene supplementation (15 mg) was given daily for 6 months. Followup laboratory tests and clinical examinations were done monthly. Changes to analgesic use and quality of life (European Organisation for Research and Treatment of Cancer QLQ-C30) were measured. The study end point was a significant change in serum prostate specific antigen, clinical progression or the end of the 6-month observation period. RESULTS: A total of 18 patients 64 to 85 years old (median age 73) were enrolled in the study during a 20-month period, of whom 17 could be analyzed. Five of the 17 patients (29%) withdrew from the study prematurely, including 4 of 5 because of prostate specific antigen progression and/or tumor associated complications, and 1 due to an allergic reaction to lycopene. Median prostate specific antigen doubled in 6 months from 42.7 ng/ml (range 13.8 to 521.6) in 17 patients to 96.4 ng/ml (range 13.5 to 1,240) in 12. Stable prostate specific antigen was observed in 5 of 17 patients (29%). None of the patients had a greater than 50% decrease in prostate specific antigen. Patients experienced a slight deterioration in mean health status at the end of the study compared to the outset. However, two-thirds of the patients experienced an improved or unchanged situation regardless of the clinical and biochemical course. CONCLUSIONS: No clinically relevant benefits were shown for patients with advanced stages of the disease.