[Prospective Multicentre Analysis of Prostate Enucleation in Patients with Prostate Volumes Below and Above 100 ml: 3-Year Follow-Up on Safety and Efficacy].

IF 0.3 4区 医学 Q4 UROLOGY & NEPHROLOGY
Sophia Hook, Christopher Netsch, Andreas J Gross, Clemens M Rosenbaum, Simon Filmar, Oliver Engel, Christian Wülfing, Benedikt Becker
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引用次数: 0

Abstract

Anatomical endoscopic enucleation of the prostate (AEEP) is an established surgical technique for the treatment of benign prostatic hyperplasia (BPH) and is increasingly adopted in clinical practice. This study aimed to prospectively compare intraoperative and long-term outcomes of AEEP in patients with prostate volumes below and above 100 ml. Key parameters included intraoperative conversion rates, 90-day complication rates, and 3-year follow-up data on reoperation rates, patient satisfaction, and involuntary urinary leakage.We analysed data from a prospective, multicentre registry of patients who underwent AEEP for BPH. Patients were divided into two groups: Group 1 (<100 ml) and Group 2 (>100 ml). Preoperative parameters such as age, prostate volume, and symptom severity were recorded. Intraoperative and postoperative complications occurring within a 90-day period were documented. The 3-year follow-up included an assessment of reoperation rates, patient satisfaction, and incontinence rate (defined as the daily use of incontinence pads).A total of 1,653 patients were included, with 1,251 assigned to Group 1 and 396 to Group 2. There were no significant differences in age or symptom severity between the groups, with the median prostate volume being 54 ml in Group 1 and 125 ml in Group 2. Intraoperative conversion rates were low in both groups (1.8% in Group 1 vs. 2.5% in Group 2). The 90-day complication rate, classified by the Clavien-Dindo system, was 40.1% in Group 1 and 52.4% in Group 2, with most complications being minor (Grade I-II). Severe complications (Grade III or higher) were rare and similarly distributed between the two groups. At 3 years, the reoperation rate was 9.1% in Group 1 and 6.4% in Group 2. Patient satisfaction remained high, with 82.3% in Group 1 and 90.5% in Group 2 reporting an improvement in quality of life two years postoperatively. The incidence of involuntary urinary leakage requiring the use of pads was 26% in Group 1 and 24.8% in Group 2 at the 3-year follow-up.This prospective, multicentre study demonstrates that AEEP is a safe and effective treatment for patients with BPH. The rate of urinary incontinence appears higher than that reported in the current literature, but it should be noted that not all cases constitute de novo incontinence. Both groups exhibited low intraoperative conversion rates, an acceptable complication profile, and comparable long-term outcomes with high patient satisfaction. These findings support the broad applicability of AEEP for both smaller and larger prostate volumes in clinical practice.

[前列腺体积小于或大于100ml的患者进行前列腺摘除的前瞻性多中心分析:安全性和有效性的3年随访]。
解剖内镜下前列腺摘除(AEEP)是治疗良性前列腺增生(BPH)的一种成熟的手术技术,越来越多地应用于临床实践。本研究旨在前瞻性比较前列腺体积小于100ml和大于100ml患者的AEEP术中和长期预后。关键参数包括术中转换率、90天并发症发生率、3年随访数据,包括再手术率、患者满意度和不自主尿漏。我们分析了一项前瞻性的、多中心的BPH患者AEEP登记数据。患者分为两组:1组(100ml)。记录年龄、前列腺体积、症状严重程度等术前参数。记录90天内发生的术中及术后并发症。3年随访包括评估再手术率、患者满意度和尿失禁率(定义为每天使用尿失禁垫)。共纳入1,653例患者,其中1,251例分配到第1组,396例分配到第2组。两组患者年龄和症状严重程度无显著差异,组1中位前列腺体积为54 ml,组2中位前列腺体积为125 ml。两组术中转换率均较低(组1为1.8%,组2为2.5%)。按Clavien-Dindo系统分类,第1组90天并发症发生率为40.1%,第2组为52.4%,大多数并发症为轻微(I-II级)。严重并发症(III级或以上)罕见,两组间分布相似。3年后,组1再手术率为9.1%,组2再手术率为6.4%。患者满意度仍然很高,第1组82.3%和第2组90.5%的患者报告术后两年的生活质量有所改善。在3年随访中,需要使用尿垫的非自愿尿漏发生率在1组为26%,在2组为24.8%。这项前瞻性的多中心研究表明,AEEP是一种安全有效的治疗前列腺增生的方法。尿失禁的发生率似乎比目前文献报道的要高,但应该注意的是,并非所有病例都构成新生尿失禁。两组均表现出较低的术中转换率,可接受的并发症概况和可比较的长期结果,患者满意度高。这些发现支持AEEP在临床实践中对前列腺体积大小的广泛适用性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Aktuelle Urologie
Aktuelle Urologie 医学-泌尿学与肾脏学
CiteScore
0.60
自引率
33.30%
发文量
104
审稿时长
>12 weeks
期刊介绍: Die entscheidenden Ergebnisse der internationalen Forschung – für Sie auf den Punkt zusammengefasst und kritisch kommentiert Übersichtsarbeiten zu den maßgeblichen Themen der täglichen Praxis Auf dem Laufenden über die klinische Forschung durch interessante Originalien CME-Punkte sammeln mit der Rubrik "Operative Techniken" In jeder Ausgabe: Techniken wichtiger Standard-OPs – Schritt für Schritt Erstklassige OP-Skizzen mit verständlichen Erläuterungen
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