A matched-pair analysis of patients with medium-sized prostates (50 cc) treated for male LUTS with HoLEP or TURP

Magistro, Giuseppe; Westhofen, Thilo; Stief, Christian G. und Weinhold, Philipp (2019): A matched-pair analysis of patients with medium-sized prostates (50 cc) treated for male LUTS with HoLEP or TURP. In: Luts-Lower Urinary Tract Symptoms, Bd. 12, Nr. 2: S. 117-122

Abstract

Objectives To evaluate perioperative parameters, early functional outcomes, and the safety profile in a matched-pair analysis of lower urinary tract symptom (LUTS) patients treated with holmium laser enucleation of the prostate (HoLEP) or transurethral resection of the prostate (TURP). Methods We conducted a retrospective, matched-pair analysis of 2011 men treated for LUTS in our institution from 2013 to 2017. In the final analysis, 197 patients (HoLEP n = 97;TURP n = 98) were matched for prostate size (50 cc), age, and body mass index, and both cohorts were compared for demographic parameters, clinical outcomes, and adverse events according to the Clavien-Dindo classification. Results The perioperative assessment revealed a significantly higher tissue retrieval percentage of 75.4% (interquartile range [IQR] 64-81.2) after HoLEP in comparison to 47.3% (IQR 40-54.7) after TURP (P <.001). A shorter surgery time was reported for TURP with a median time of 55.5 minutes (IQR 48-70.5), whereas the median time for HoLEP was 62 minutes (IQR 51-85) (P =.006). The median improvements in International Prostate Symptom Score (IPSS) were 11 points (IQR 5.5-17) and 7 points (IQR 3-14) for HoLEP and TURP, respectively (P =.007). Peak urinary flow rate (Q(max)) increased more after HoLEP (12.0 mL/s;IQR 7-23) than after TURP (8.5 mL/s;IQR 5-18.25) (P =.028). With an overall incidence of adverse events of 6% (n = 6) compared to 16% (n = 16%), significantly fewer complications occurred after HoLEP than after treatment with TURP (P <.05). Conclusions HoLEP is not only an attractive alternative for the enucleation of larger prostates, but it must be considered a size-independent technique with the potential to outdo the current reference method TURP.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1757-5664
• Sprache: Englisch