Risk factors for long-term outcome in photoselective vaporization of the prostate

• Verfasst von: Popeneciu, Valentin [VerfasserIn]
• Verfasst von: Hatiboglu, Gencay [VerfasserIn]
• Verfasst von: Kuru, Timur Hasan [VerfasserIn]
• Verfasst von: Milakovic, Sandra [VerfasserIn]
• Verfasst von: Freier, Gerald Jörg [VerfasserIn]
• Verfasst von: Hadaschik, Boris [VerfasserIn]
• Verfasst von: Hohenfellner, Markus [VerfasserIn]
• Verfasst von: Pahernik, Sascha [VerfasserIn]
• Titel: Risk factors for long-term outcome in photoselective vaporization of the prostate
• Verf.angabe: Ionel Valentin Popeneciu, Gencay Hatiboglu, Timur Hassan Kuru, Sandra Milakovic, Gerald Freier, Boris Hadaschik, Markus Hohenfellner and Sascha Pahernik
• E-Jahr: 2016
• Jahr: 29 Apr 2016
• Umfang: 6 S.
• Fussnoten: Published online: 29 Apr 2016 ; Gesehen am 03.11.2020
• Titel Quelle: Enthalten in: Scandinavian journal of urology
• Ort Quelle: Abingdon : Taylor & Francis, 2013
• Jahr Quelle: 2016
• Band/Heft Quelle: 50(2016), 4, Seite 313-318
• ISSN Quelle: 2168-1813
• DOI: doi:10.3109/21681805.2016.1172253
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Adult
• Sach-SW: Aged
• Sach-SW: Aged, 80 and over
• Sach-SW: Benign prostatic obstruction
• Sach-SW: Cohort Studies
• Sach-SW: GreenLight laser
• Sach-SW: Humans
• Sach-SW: long-term follow-up
• Sach-SW: lower urinary tract symptoms
• Sach-SW: Male
• Sach-SW: Middle Aged
• Sach-SW: photoselective vaporization of the prostate
• Sach-SW: prostate vaporization
• Sach-SW: Prostatic Hyperplasia
• Sach-SW: reintervention
• Sach-SW: Retrospective Studies
• Sach-SW: risk factors
• Sach-SW: Risk Factors
• Sach-SW: Time Factors
• Sach-SW: Transurethral Resection of Prostate
• Sach-SW: Treatment Outcome
• K10plus-PPN: 1737691442

Abstract

OBJECTIVE: The aim of this retrospective cohort study was to investigate long-term risk factors for reintervention after photoselective vaporization of the prostate (PVP). - MATERIAL AND METHODS: In total, 566 consecutive patients with benign prostatic hyperplasia (BPH) underwent PVP between February 2005 and April 2011. Mean follow-up was 36.42 ± 21.4 months. Perioperative parameters were evaluated, including surgery time, delivered energy, catheterization and duration of hospitalization, intraoperative and postoperative complications, as well as reintervention rates in manifest reobstruction. Follow-up comprised the International Prostate Symptom Score and quality of life questionnaire (IPPS-QoL), maximal flow rate (Qmax) and postvoiding residual volume (PVR). - RESULTS: Mean operation time was 69.8 ± 29.3 min. Mean catheterization and hospitalization times were 1.49 ± 1.19 days and 2.67 ± 2.19 days, respectively. There was ongoing oral anticoagulation for 20.1% of the patients (n = 114). The overall retreatment rate was 17.6% (101 out of 566 patients) after a mean time of 9.21 months (range 0-64 months). Of these, 88 patients (15.55%) had a reobstruction and 13 (2.3%) had urethral strictures. In multivariate analysis, age, prostate volume, total applied energy, specific laser energy usage, preoperative symptomatic (IPSS/QoL) and functional obstruction grade (Qmax/PVR) were not identified as risk factors for reintervention. A poor postoperative Qmax (< 15 ml/s) measured immediately after removal of the transurethral catheter was identified as a risk factor for undergoing a reintervention (p = 0.005). - CONCLUSIONS: PVP is an effective method for BPH treatment, allowing for sustained long-term improvement of the voiding function. Poor immediate postoperative urinary flow after removal of the transurethral catheter (Qmax < 15 ml/s) is a significant risk factor for reintervention.