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Greenlight laser (XPS(TM)) 180W prostatectomy for treatment of benign prostate hyperplasia in patients with uncorrectable bleeding tendency

OBJECTIVES: Safety of GreenLight™ laser prostatectomy (GL-LP) in patients with ongoing blood thinners has been proven. Yet, the possibility of drug manipulation makes it a less challenging situation compared to treating patients with uncorrectable bleeding tendency. Herein, we aim at evaluating the...

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Autores principales: Elshal, Ahmed M., Ghobrial, Fady K., Laymon, Mahmoud, Elegeezy, Mohamed, El-Nahas, Ahmed R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10208207/
https://www.ncbi.nlm.nih.gov/pubmed/37234681
http://dx.doi.org/10.1080/2090598X.2022.2156655
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author Elshal, Ahmed M.
Ghobrial, Fady K.
Laymon, Mahmoud
Elegeezy, Mohamed
El-Nahas, Ahmed R.
author_facet Elshal, Ahmed M.
Ghobrial, Fady K.
Laymon, Mahmoud
Elegeezy, Mohamed
El-Nahas, Ahmed R.
author_sort Elshal, Ahmed M.
collection PubMed
description OBJECTIVES: Safety of GreenLight™ laser prostatectomy (GL-LP) in patients with ongoing blood thinners has been proven. Yet, the possibility of drug manipulation makes it a less challenging situation compared to treating patients with uncorrectable bleeding tendency. Herein, we aim at evaluating the outcomes of XPS™-180 W GL-LP for treatment of BPH in patients who had uncorrectable bleeding tendency due to hepatic dysfunction. METHODS: A prospectively maintained database for all patients who underwent GL-LP for symptomatic BPH was reviewed. Patients were divided into two groups based on the degree of hepatic dysfunction using Fib-4 index: Group 1 (indexed patients; low-risk Fib-4) and Group 2 (non-indexed patients; intermediate-high-risk Fib-4) included those who had chronic liver disease associated with either thrombocytopenia and/or hypoprothrombinemia. Primary outcome was the difference in perioperative bleeding complications between the two groups. Other outcome measures included all perioperative findings and complications as well-functional outcome measures. RESULTS: The study included 140 patients (93 indexed patients and 47 non-indexed). There were no significant differences between both groups in operative time, laser time and energy, auxiliary procedures, catheter time, hospital stay, and hemoglobin deficit. The need for blood transfusion was significantly more in group 2 (two patients (4.3%) versus no patients in group 1, P = 0.045). Perioperative and late postoperative complications were comparable for both groups (P = 0.634 and 0.858, respectively). There were no significant differences in the postoperative uroflow, symptoms score, and PSA reduction between the two groups (P = 0.57, 0.87, and 0.05, respectively). CONCLUSIONS: XPS™-180 W GL-LP is a safe and effective technique for treatment of BPH in patients with uncorrectable bleeding tendency due to hepatic dysfunction.
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spelling pubmed-102082072023-05-25 Greenlight laser (XPS(TM)) 180W prostatectomy for treatment of benign prostate hyperplasia in patients with uncorrectable bleeding tendency Elshal, Ahmed M. Ghobrial, Fady K. Laymon, Mahmoud Elegeezy, Mohamed El-Nahas, Ahmed R. Arab J Urol Benign Prostatic Hyperpulsia OBJECTIVES: Safety of GreenLight™ laser prostatectomy (GL-LP) in patients with ongoing blood thinners has been proven. Yet, the possibility of drug manipulation makes it a less challenging situation compared to treating patients with uncorrectable bleeding tendency. Herein, we aim at evaluating the outcomes of XPS™-180 W GL-LP for treatment of BPH in patients who had uncorrectable bleeding tendency due to hepatic dysfunction. METHODS: A prospectively maintained database for all patients who underwent GL-LP for symptomatic BPH was reviewed. Patients were divided into two groups based on the degree of hepatic dysfunction using Fib-4 index: Group 1 (indexed patients; low-risk Fib-4) and Group 2 (non-indexed patients; intermediate-high-risk Fib-4) included those who had chronic liver disease associated with either thrombocytopenia and/or hypoprothrombinemia. Primary outcome was the difference in perioperative bleeding complications between the two groups. Other outcome measures included all perioperative findings and complications as well-functional outcome measures. RESULTS: The study included 140 patients (93 indexed patients and 47 non-indexed). There were no significant differences between both groups in operative time, laser time and energy, auxiliary procedures, catheter time, hospital stay, and hemoglobin deficit. The need for blood transfusion was significantly more in group 2 (two patients (4.3%) versus no patients in group 1, P = 0.045). Perioperative and late postoperative complications were comparable for both groups (P = 0.634 and 0.858, respectively). There were no significant differences in the postoperative uroflow, symptoms score, and PSA reduction between the two groups (P = 0.57, 0.87, and 0.05, respectively). CONCLUSIONS: XPS™-180 W GL-LP is a safe and effective technique for treatment of BPH in patients with uncorrectable bleeding tendency due to hepatic dysfunction. Taylor & Francis 2022-12-15 /pmc/articles/PMC10208207/ /pubmed/37234681 http://dx.doi.org/10.1080/2090598X.2022.2156655 Text en © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Benign Prostatic Hyperpulsia
Elshal, Ahmed M.
Ghobrial, Fady K.
Laymon, Mahmoud
Elegeezy, Mohamed
El-Nahas, Ahmed R.
Greenlight laser (XPS(TM)) 180W prostatectomy for treatment of benign prostate hyperplasia in patients with uncorrectable bleeding tendency
title Greenlight laser (XPS(TM)) 180W prostatectomy for treatment of benign prostate hyperplasia in patients with uncorrectable bleeding tendency
title_full Greenlight laser (XPS(TM)) 180W prostatectomy for treatment of benign prostate hyperplasia in patients with uncorrectable bleeding tendency
title_fullStr Greenlight laser (XPS(TM)) 180W prostatectomy for treatment of benign prostate hyperplasia in patients with uncorrectable bleeding tendency
title_full_unstemmed Greenlight laser (XPS(TM)) 180W prostatectomy for treatment of benign prostate hyperplasia in patients with uncorrectable bleeding tendency
title_short Greenlight laser (XPS(TM)) 180W prostatectomy for treatment of benign prostate hyperplasia in patients with uncorrectable bleeding tendency
title_sort greenlight laser (xps(tm)) 180w prostatectomy for treatment of benign prostate hyperplasia in patients with uncorrectable bleeding tendency
topic Benign Prostatic Hyperpulsia
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10208207/
https://www.ncbi.nlm.nih.gov/pubmed/37234681
http://dx.doi.org/10.1080/2090598X.2022.2156655
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