Predictors of early catheter replacement after HoLEP. Results from a high-volume laser center.
Int Braz J Urol
; 49(5): 608-618, 2023.
Article
em En
| MEDLINE
| ID: mdl-37506034
ABSTRACT
INTRODUCTION:
The aim of the study was to investigate clinical and surgical factors associated with early catheter replacement in patients treated with Holmium Laser Enucleation of the Prostate (HoLEP). MATERIALS ANDMETHODS:
Data of patients treated with HoLEP at our Institution by a single surgeon from March 2017 to January 2021 were collected. Preoperative variables, including non-invasive uroflowmetry and abdominal ultrasonography (US), were recorded. Bladder wall modifications (BWM) at preoperative US were defined as the presence of single or multiple bladder diverticula or bladder wall thickening 5 mm. Clinical symptoms were assessed using validated questionnaires. Only events occurred within the first week after catheter removal were considered.RESULTS:
Overall, 305 patients were included, of which 46 (15.1%) experienced early catheter replacement. Maintenance of anticoagulants/antiplatelets (AC/AP) therapy at surgery (p=0.001), indwelling urinary catheter (p=0.02) and the presence of BWM (p=0.001) were more frequently reported in patients needing postoperative re-catheterization. Intraoperative complications (p=0.02) and median lasing time (p=0.02) were significantly higher in this group. At univariate analysis, indwelling urinary catheter (p=0.02), BWM (p=0.01), ongoing AC/AP therapy (p=0.01) and intraoperative complications (p=0.01) were significantly associated with early catheter replacement. At multivariate analysis, indwelling urinary catheter (OR 1.28; p=0.02), BWM (OR 2.87; p=0.001), and AC/AP therapy (OR 2.21; p=0.01) were confirmed as independent predictors of catheter replacement.CONCLUSIONS:
In our experience the presence of indwelling urinary catheter before surgery, BWM and the maintenance of AC/AP therapy were shown to be independent predictors of early catheter replacement after HoLEP.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Hiperplasia Prostática
/
Ressecção Transuretral da Próstata
/
Terapia a Laser
/
Lasers de Estado Sólido
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
/
Male
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article