Holmium laser enucleation of prostate in nonagenarians and octogenarians Impact of age and frailty on surgical outcomes.
Can Urol Assoc J
; 17(9): E263-E268, 2023 Sep.
Article
em En
| MEDLINE
| ID: mdl-37458738
ABSTRACT
INTRODUCTION:
Holmium laser enucleation of the prostate (HoLEP) is a well-established technique for management of benign prostatic hyperplasia (BPH). With the growing aging population, a considerable percentage of octogenarians (80-90 years old) and nonagenarians (>90 years old) require surgical management for BPH. We aimed to assess the outcomes of HoLEP in those age groups.METHODS:
We reviewed a maintained database for HoLEP patients in a tertiary center. Patients were assigned to two groups above (group A) and below (group B) 80 years old. Perioperative outcome and postoperative followup data were compared between both groups.RESULTS:
The study included 1090 patients, 201 and 889 in groups A and B, respectively. Median age was 83 and 70 years in groups A and B, respectively. Group A showed longer operative time, longer catheterization time, and higher 30-day emergency room visits and readmission rates. Hemoglobin drop was comparable, although associated with higher rate of blood transfusion in group A. Overall, 30-day postoperative complications were higher in group A (20.8% vs. 9.3%, p=0.008), although the majority of complications in both groups were grade I and II. The rate of complications over Clavien-Dindo grade II were statistically comparable (3.4% vs. 1.79%, p=0.133). Followup at six weeks, three months, and one year showed comparable functional outcomes in both groups.CONCLUSIONS:
HoLEP is a safe and effective option in the geriatric population of octogenarians and even nonagenarians. HoLEP is associated with higher overall complication rate in older age groups; however, most complications were minor.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Idioma:
En
Revista:
Can Urol Assoc J
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Estados Unidos