Comparison of postoperative functional results in holmium laser enucleation of the prostate, green laser photovaporization of the prostate and transurethral resection of the prostate in the treatment of obstructive prostatic hyperplasia
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v82i3.743Keywords:
HOLEP, FTV, TURP, functional results, enucleation, prostateAbstract
Objective: To compare the functional results in patients undergoing transurethral resection of the prostate (TURP), photovaporization of the prostate with GreenLight ® laser (FTV) and prostate enucleation with Holmium laser (HOLEP), for the treatment of benign prostatic obstruction at the Central Military Hospital.
Material and methods: The international index of prostate symptomatology questionnaire (IPSS), Uroflowmetry (Qmax), pre and post void ultrasonography (PVR) were applied to patients undergoing TURP, VTF and HOLEP pre and postoperatory from January 2018 to March 2019. Shapiro-Wilks tests were analyzed for quantitative variables; parametric behavioral data were analyzed with ANOVA tests, and non-parametric data were analyzed with Mann-Whitney and Kruskal-Wallis U tests. GraphPad PRISM v7.0 statistical package was used.
Results: 46 patients underwent to TURP, 62 to HOLEP and 17 to VFT were evaluated, removing those who did not achieve complete postoperative follow-up; describing the demographic characteristics, the most frequent comorbidities and the parameters evaluated preoperatively. At follow-up, HOLEP was slightly better than FTV or TURP; without finding statistical significance between the groups, observing an important improvement in the reference values of IPSS, Qmax and PVR after surgery in all populations.
Conclusions: No superiority of any technique was proven in short-term postoperative functional results, so we propose to perform long-term studies, considering adding trans and postoperative parameters in order to demonstrate superiority of these techniques.
References
Wein AJ, Kavoussi LR, Partin AW, Peters CA. Campbell-Walsh Urology 11th Edition Review. Elsevier Health Sciences; 2015. 624 p.
Ricci Arriola P, Solá Dalenz V, Pardo Schanz J. Estudio de la incontinencia de orina femenina mediante urodinamia monocanal: comparación con los síntomas de ingreso. Análisis de 590 mujeres. Archivos Españoles de Urología (Ed impresa). 2009 Mar;62(2):115–23.
McAninch J, Lue T. Urolgía General Smith y Tanagho. México: McGraw-Hill; 2014. 758 p.
Thomas JA, Tubaro A, Barber N, d’Ancona F, Muir G, Witzsch U, et al. A Multicenter Randomized Noninferiority Trial Comparing GreenLight-XPS Laser Vaporization of the Prostate and Transurethral Resection of the Prostate for the Treatment of Benign Prostatic Obstruction: Two-yr Outcomes of the GOLIATH Study. Eur Urol. 2016;69(1):94–102. doi: 10.1016/j.eururo.2015.07.054
Mavuduru RM, Mandal AK, Singh SK, Acharya N, Agarwal M, Garg S, et al. Comparison of HoLEP and TURP in terms of efficacy in the early postoperative period and perioperative morbidity. Urol Int. 2009;82(2):130–5. doi: https://doi.org/10.1159/000200786
Kim M, Lee H-E, Oh S-J. Technical aspects of holmium laser enucleation of the prostate for benign prostatic hyperplasia. Korean J Urol. 2013 Sep;54(9):570–9. doi: https://doi.org/10.4111/kju.2013.54.9.570
Zhang Z-H, Luo F, Su Y-H, Li J. Management of greenlight laser plus transurethral resection of prostate for elderly men. Medicine (Baltimore). 2018 Aug;97(33):e11862. doi: 10.1097/MD.0000000000011862
Stone BV, Chughtai B, Kaplan SA, Te AE, Lee RK. GreenLight laser for prostates over 100 ml: what is the evidence? Curr Opin Urol. 2016 Jan;26(1):28–34. doi: https://doi.org/10.1097/mou.0000000000000237
Sun I, Yoo S, Park J, Cho SY, Jeong H, Son H, et al. Quality of life after photo-selective vaporization and holmium-laser enucleation of the prostate: 5-year outcomes. Sci Rep. 2019 Jun 4;9(1):8261. doi: https://doi.org/10.1038/s41598-019-44686-2
Chughtai B, Forde JC, Thomas DDM, Laor L, Hossack T, Woo HH, et al. Benign prostatic hyperplasia. Nat Rev Dis Primers. 2016 May 5;2:16031. doi: https://doi.org/10.1038/nrdp.2016.31
Platz EA, Joshu CE, Mondul AM, Peskoe SB, Willett WC, Giovannucci E. Incidence and Progression of Lower Urinary Tract Symptoms in a Large Prospective Cohort of US Men. J Urol. 2012 Aug;188(2):496–501. doi: https://dx.doi.org/10.1016%2Fj.juro.2012.03.125
Bosch JLHR, Hop WCJ, Kirkels WJ, Schröder FH. Natural history of benign prostatic hyperplasia: Appropriate case definition and estimation of its prevalence in the community. Urology. 1995 Sep 1;46(3):34–40. doi: https://doi.org/10.1016/S0090-4295(99)80248-9
Jin B, Turner L, Zhou Z, Zhou EL, Handelsman DJ. Ethnicity and migration as determinants of human prostate size. J Clin Endocrinol Metab. 1999 Oct;84(10):3613–9. doi: https://doi.org/10.1210/jcem.84.10.6041
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