Does the use of a small-size resectoscope during enucleation prevent transient urinary leakage and urethral stricture following holmium laser enucleation of the prostate?

IF 1.5 4区 医学 Q3 UROLOGY & NEPHROLOGY
LUTS: Lower Urinary Tract Symptoms Pub Date : 2022-03-01 Epub Date: 2021-11-08 DOI:10.1111/luts.12414
Muhammed Arif Ibis, Zafer Tokatlı
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引用次数: 2

Abstract

Objective: To investigate the effect of the use of a small-size resectoscope for enucleation during holmium laser enucleation of the prostate (HoLEP) on the prevention of transient urinary leakage (TUL) and urethral stricture (US).

Methods: One hundred patients were included in a retrospective single-center study from January 2019 to December 2020. The patients were divided into two groups according to the resectoscope size which was used for enucleation (22F in group A [n = 40] and 26F in group B [n = 60]). Patients were evaluated at 4, 12, and 24 weeks postoperatively for TUL and US. Univariate and multivariate regression analyses were implemented to assess the variables which are associated with TUL at 4 weeks.

Results: Baseline characteristics and perioperative data were observed to be well balanced between groups. A statistically significant higher occurrence of TUL was detected at 4 weeks in group B compared to group A (P = .018). Higher improvement in International Prostate Symptom Score (IPSS) and quality of life (QoL) was observed in group A at 4 and 12 weeks postoperatively. On univariate analysis, resectoscope size, specimen weight, and body mass index were significant predictive factors for TUL at 4 weeks. Multivariate analysis illustrated that the resectoscope size was independently associated with TUL at 4 weeks after HoLEP (odds ratio = 3.1 [1.02-9.38]). One patient in group A (2.5%) and two patients in group B (5%) demonstrated US (P = .648).

Conclusion: Enucleation with a 22F resectoscope provides better QoL and IPSS by reducing TUL rates in the early postoperative period.

在切除过程中使用小尺寸切除镜是否能预防钬激光前列腺切除后的短暂性尿漏和尿道狭窄?
目的:探讨钬激光前列腺摘除术(HoLEP)中应用小尺寸切除镜对预防短暂性尿漏(TUL)和尿道狭窄(US)的效果。方法:2019年1月至2020年12月,对100例患者进行回顾性单中心研究。根据切除镜大小将患者分为两组(A组22F [n = 40], B组26F [n = 60])。分别于术后4周、12周和24周评估患者的TUL和US。采用单因素和多因素回归分析评估与4周TUL相关的变量。结果:两组患者的基线特征和围手术期数据平衡良好。4周时,B组TUL发生率高于A组,差异有统计学意义(P = 0.018)。A组患者术后4周和12周的国际前列腺症状评分(IPSS)和生活质量(QoL)均有明显改善。单因素分析显示,切除镜大小、标本重量和体重指数是4周TUL的显著预测因素。多因素分析显示,HoLEP术后4周切除镜大小与TUL独立相关(优势比= 3.1[1.02-9.38])。A组1例(2.5%),B组2例(5%)出现US (P = .648)。结论:22F切除镜下眼球摘除术可降低术后早期TUL发生率,提高患者的生活质量和IPSS。
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来源期刊
LUTS: Lower Urinary Tract Symptoms
LUTS: Lower Urinary Tract Symptoms UROLOGY & NEPHROLOGY-
CiteScore
3.00
自引率
7.70%
发文量
52
审稿时长
>12 weeks
期刊介绍: LUTS is designed for the timely communication of peer-reviewed studies which provides new clinical and basic science information to physicians and researchers in the field of neurourology, urodynamics and urogynecology. Contributions are reviewed and selected by a group of distinguished referees from around the world, some of whom constitute the journal''s Editorial Board. The journal covers both basic and clinical research on lower urinary tract dysfunctions (LUTD), such as overactive bladder (OAB), detrusor underactivity, benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO), urinary incontinence, pelvic organ prolapse (POP), painful bladder syndrome (PBS), as well as on other relevant conditions. Case reports are published only if new findings are provided. LUTS is an official journal of the Japanese Continence Society, the Korean Continence Society, and the Taiwanese Continence Society. Submission of papers from all countries are welcome. LUTS has been accepted into Science Citation Index Expanded (SCIE) with a 2011 Impact Factor.
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