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Risk Factors for Transurethral Coagulation for Hemostasis During Holmium Laser Enucleation of the Prostate

PURPOSE: We aimed to identify risk factors for transurethral coagulation (TUC) using bipolar electrocautery for hemostasis during holmium laser enucleation of the prostate (HoLEP) surgery for benign prostatic hyperplasia (BPH). METHODS: We analyzed the clinical outcomes of HoLEP surgery performed by...

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Autores principales: Yoon, Hyun Sik, Kim, Min Hyuk, Park, Jae Suk, Choo, Min Soo, Jeong, Seong Jin, Oh, Seung-June
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Continence Society 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9260329/
https://www.ncbi.nlm.nih.gov/pubmed/35793994
http://dx.doi.org/10.5213/inj.2142414.207
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author Yoon, Hyun Sik
Kim, Min Hyuk
Park, Jae Suk
Choo, Min Soo
Jeong, Seong Jin
Oh, Seung-June
author_facet Yoon, Hyun Sik
Kim, Min Hyuk
Park, Jae Suk
Choo, Min Soo
Jeong, Seong Jin
Oh, Seung-June
author_sort Yoon, Hyun Sik
collection PubMed
description PURPOSE: We aimed to identify risk factors for transurethral coagulation (TUC) using bipolar electrocautery for hemostasis during holmium laser enucleation of the prostate (HoLEP) surgery for benign prostatic hyperplasia (BPH). METHODS: We analyzed the clinical outcomes of HoLEP surgery performed by a single surgeon between January 2010 and April 2020 at the Seoul National University Hospital. Patient characteristics and perioperative parameters were used to identify the risk factors for TUC. The TUC group was defined as a case of conversion to hemostasis using electrocautery during the hemostasis step after enucleation. RESULTS: Of 1,563 patients, 357 underwent TUC (TUC group; 22.8%) as an adjuvant (n=299, 19.1%) or salvage (n=58, 3.7%) therapy. Patients in the TUC group were older (mean±standard deviation, 70.6±7.3 years vs. 69.3±7.0 years; P=0.002), had more 5-alpha reductase inhibitor (5-ARI) use (35.6% vs. 25.9%, P<0.001), higher serum prostate-specific antigen (PSA) (5.4 ±4.8 ng/mL vs. 3.8 ±4.5 ng/mL, P <0.001), larger total prostate volume (TPV) (89.5 ±44.7 mL vs. 66.0 ±32.6 mL, P<0.001), and larger transitional zone volume (TZV) (57.3±34.9 mL vs. 37.7±24.2 mL, P<0.001) than those who did not undergo TUC (non-TUC group). In univariate logistic regression analysis, age, 5-ARI use, PSA, TPV, and TZV correlated with TUC, whereas in multivariate logistic regression analysis, only TZV was associated with TUC. The odds ratios (ORs) of TUC were analyzed per TZV quartile. Compared to TZV<22.3 mL, the OR was 2.42 in 34.1 mL≤TZV<53.5 mL (95% confidence interval [CI], 1.58–3.72; P<0.001), 5.17 in ≥53.5 mL (95% CI, 3.44–7.77; P<0.001). CONCLUSIONS: The risk of TUC during HoLEP surgery increases in patients with TZV >35 mL. Therefore, TUC may be potentially necessary in patients with a large transition zone volume in patients with BPH.
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spelling pubmed-92603292022-07-18 Risk Factors for Transurethral Coagulation for Hemostasis During Holmium Laser Enucleation of the Prostate Yoon, Hyun Sik Kim, Min Hyuk Park, Jae Suk Choo, Min Soo Jeong, Seong Jin Oh, Seung-June Int Neurourol J Original Article PURPOSE: We aimed to identify risk factors for transurethral coagulation (TUC) using bipolar electrocautery for hemostasis during holmium laser enucleation of the prostate (HoLEP) surgery for benign prostatic hyperplasia (BPH). METHODS: We analyzed the clinical outcomes of HoLEP surgery performed by a single surgeon between January 2010 and April 2020 at the Seoul National University Hospital. Patient characteristics and perioperative parameters were used to identify the risk factors for TUC. The TUC group was defined as a case of conversion to hemostasis using electrocautery during the hemostasis step after enucleation. RESULTS: Of 1,563 patients, 357 underwent TUC (TUC group; 22.8%) as an adjuvant (n=299, 19.1%) or salvage (n=58, 3.7%) therapy. Patients in the TUC group were older (mean±standard deviation, 70.6±7.3 years vs. 69.3±7.0 years; P=0.002), had more 5-alpha reductase inhibitor (5-ARI) use (35.6% vs. 25.9%, P<0.001), higher serum prostate-specific antigen (PSA) (5.4 ±4.8 ng/mL vs. 3.8 ±4.5 ng/mL, P <0.001), larger total prostate volume (TPV) (89.5 ±44.7 mL vs. 66.0 ±32.6 mL, P<0.001), and larger transitional zone volume (TZV) (57.3±34.9 mL vs. 37.7±24.2 mL, P<0.001) than those who did not undergo TUC (non-TUC group). In univariate logistic regression analysis, age, 5-ARI use, PSA, TPV, and TZV correlated with TUC, whereas in multivariate logistic regression analysis, only TZV was associated with TUC. The odds ratios (ORs) of TUC were analyzed per TZV quartile. Compared to TZV<22.3 mL, the OR was 2.42 in 34.1 mL≤TZV<53.5 mL (95% confidence interval [CI], 1.58–3.72; P<0.001), 5.17 in ≥53.5 mL (95% CI, 3.44–7.77; P<0.001). CONCLUSIONS: The risk of TUC during HoLEP surgery increases in patients with TZV >35 mL. Therefore, TUC may be potentially necessary in patients with a large transition zone volume in patients with BPH. Korean Continence Society 2022-06 2022-06-30 /pmc/articles/PMC9260329/ /pubmed/35793994 http://dx.doi.org/10.5213/inj.2142414.207 Text en Copyright © 2022 Korean Continence Society https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Yoon, Hyun Sik
Kim, Min Hyuk
Park, Jae Suk
Choo, Min Soo
Jeong, Seong Jin
Oh, Seung-June
Risk Factors for Transurethral Coagulation for Hemostasis During Holmium Laser Enucleation of the Prostate
title Risk Factors for Transurethral Coagulation for Hemostasis During Holmium Laser Enucleation of the Prostate
title_full Risk Factors for Transurethral Coagulation for Hemostasis During Holmium Laser Enucleation of the Prostate
title_fullStr Risk Factors for Transurethral Coagulation for Hemostasis During Holmium Laser Enucleation of the Prostate
title_full_unstemmed Risk Factors for Transurethral Coagulation for Hemostasis During Holmium Laser Enucleation of the Prostate
title_short Risk Factors for Transurethral Coagulation for Hemostasis During Holmium Laser Enucleation of the Prostate
title_sort risk factors for transurethral coagulation for hemostasis during holmium laser enucleation of the prostate
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9260329/
https://www.ncbi.nlm.nih.gov/pubmed/35793994
http://dx.doi.org/10.5213/inj.2142414.207
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