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Effect of detrusor underactivity on surgical outcomes of holmium laser enucleation of the prostate.
Jeong, Hyun Ju; Lee, Hyomyoung; Choo, Min Soo; Cho, Sung Yong; Jeong, Seong Jin; Oh, Seung-June.
Afiliação
  • Jeong HJ; Department of Medical Device Development, Seoul National University College of Medicine, Seoul, Korea.
  • Lee H; Department of Urology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
  • Choo MS; Department of Urology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
  • Cho SY; Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea.
  • Jeong SJ; Department of Medical Device Development, Seoul National University College of Medicine, Seoul, Korea.
  • Oh SJ; Department of Urology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
BJU Int ; 133(6): 770-777, 2024 Jun.
Article em En | MEDLINE | ID: mdl-38520132
ABSTRACT

OBJECTIVE:

To evaluate the effect of detrusor underactivity (DUA) on the postoperative outcomes of holmium laser enucleation of the prostate (HoLEP) in patients with benign prostatic hyperplasia (BPH). PATIENTS AND

METHODS:

Patients with BPH who underwent HoLEP between January 2018 and December 2022 were enrolled in this prospective database study. Patients were divided into DUA (bladder contractility index [BCI] <100) and non-DUA (BCI ≥100) groups. Objective (maximum urinary flow rate [Qmax], post-void residual urine volume [PVR]) and subjective outcomes (International Prostate Symptom Score [IPSS], Overactive Bladder Symptom Score [OABSS], satisfaction with treatment question [STQ], overall response assessment [ORA], and willingness to undergo surgery question [WUSQ]) were compared between the two groups before surgery, and at 3 and 6 months after HoLEP.

RESULTS:

A total of 689 patients, with a mean (standard deviation [SD]) age of 69.8 (7.1) years, were enrolled. The mean (SD) BCI in the non-DUA (325 [47.2%]) and DUA (364 [52.8%]) groups was 123.4 (21.4) and 78.6 (14.2), respectively. Both objective (Qmax and PVR) and subjective (IPSS, IPSS-quality of life, and OABSS) outcomes after surgery significantly improved in both groups. The Qmax was lower in the DUA than in the non-DUA group postoperatively. At 6 months postoperatively, the total IPSS was higher in the DUA than in the non-DUA group. There were no significant differences in surgical complications between the two groups. Responses to the STQ, ORA, and WUSQ at 6 months postoperatively demonstrated that the patients were satisfied with the surgery (90.5% in the DUA group; 95.2% in the non-DUA group), their symptoms improved with surgery (95.9% in the DUA group; 100.0% in the non-DUA group), and they were willing to undergo surgery again (95.9% in the DUA group; 97.9% in the non-DUA group). There were no significant differences in the responses to the STQ and WUSQ between the two groups.

CONCLUSION:

Our midterm results demonstrated that patients with BPH and DUA showed minimal differences in clinical outcomes after HoLEP compared to those without DUA. The overall satisfaction was high in the DUA group.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Prostatectomia / Hiperplasia Prostática / Lasers de Estado Sólido / Bexiga Inativa Limite: Aged / Humans / Male / Middle aged Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Prostatectomia / Hiperplasia Prostática / Lasers de Estado Sólido / Bexiga Inativa Limite: Aged / Humans / Male / Middle aged Idioma: En Ano de publicação: 2024 Tipo de documento: Article