Clarissa Wong, Perry Xu, Meera Ganesh, Nabila Reem Khondakar, Luis Gago, Dimitri Speron, Kyle Tsai, Alyssa McDonald, Allaa Fadl-Alla, Nicholas Dean, Amy Krambeck
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Date of surgical case request placement, date of complication occurrence, and date of HoLEP were recorded. Preoperative, intraoperative, and postoperative characteristics were collected and analyzed. Statistical analysis was performed with SPSS software with p < 0.05 denoting significance.</p><p><strong>Results: </strong>We identified 918 patients in the database in this timeframe, with 74 experiencing a complication while waiting for HoLEP. Mean preoperative prostate volume was 122.7 ml. Complications included 8 cardiac and 37 urologic events. Complications were associated with a 31.2-day increase in wait time. Patients with cardiac complications waited 113.5 days (p = 0.013). Patients who had a complication while waiting were more likely to be on benign prostatic hyperplasia (BPH) medications, be catheter dependent, and have urinary tract infections (UTI) within 6 months of surgery. The 90-day postoperative complication rate was 31.5% in the complication group and 20.4% in the non-complication group. Patients who experienced a wait time complication were also more likely to have prolonged postoperative catheter duration and increased emergency room visits.</p><p><strong>Conclusion: </strong>Patients with history of UTI and catheter dependence are more likely to experience a complication while waiting for HoLEP. Having a wait time complication can significantly delay surgery date by up to 30 days, and patients experiencing complication preoperatively are more likely to experience further complications postoperatively. Efforts are needed to expedite and improve access to necessary BPH procedures.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"499"},"PeriodicalIF":2.9000,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Waiting for HoLEP-outcomes when complications arise in the preoperative period.\",\"authors\":\"Clarissa Wong, Perry Xu, Meera Ganesh, Nabila Reem Khondakar, Luis Gago, Dimitri Speron, Kyle Tsai, Alyssa McDonald, Allaa Fadl-Alla, Nicholas Dean, Amy Krambeck\",\"doi\":\"10.1007/s00345-025-05871-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Surgery for benign prostatic hyperplasia (BPH), including holmium laser enucleation of the prostate (HoLEP), is often considered to be elective, leading to many patients waiting for intervention. Wait times for HoLEP can vary on many factors, but the incidence and impact of complications in this preoperative waiting period are unknown. We sought to uncover the outcomes of HoLEP in patients who experienced a complication while waiting for surgery.</p><p><strong>Methods: </strong>We performed a retrospective review of a prospectively maintained database of patients who underwent HoLEP at a high-volume center between January 2021 and August 2023. Date of surgical case request placement, date of complication occurrence, and date of HoLEP were recorded. Preoperative, intraoperative, and postoperative characteristics were collected and analyzed. Statistical analysis was performed with SPSS software with p < 0.05 denoting significance.</p><p><strong>Results: </strong>We identified 918 patients in the database in this timeframe, with 74 experiencing a complication while waiting for HoLEP. Mean preoperative prostate volume was 122.7 ml. Complications included 8 cardiac and 37 urologic events. Complications were associated with a 31.2-day increase in wait time. Patients with cardiac complications waited 113.5 days (p = 0.013). Patients who had a complication while waiting were more likely to be on benign prostatic hyperplasia (BPH) medications, be catheter dependent, and have urinary tract infections (UTI) within 6 months of surgery. The 90-day postoperative complication rate was 31.5% in the complication group and 20.4% in the non-complication group. Patients who experienced a wait time complication were also more likely to have prolonged postoperative catheter duration and increased emergency room visits.</p><p><strong>Conclusion: </strong>Patients with history of UTI and catheter dependence are more likely to experience a complication while waiting for HoLEP. 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引用次数: 0
摘要
目的:良性前列腺增生(BPH)的手术,包括钬激光前列腺摘除(HoLEP),通常被认为是选择性的,导致许多患者等待干预。HoLEP的等待时间可能因多种因素而异,但术前等待期并发症的发生率和影响尚不清楚。我们试图揭示HoLEP在等待手术期间出现并发症的患者中的结果。方法:我们对2021年1月至2023年8月期间在高容量中心接受HoLEP的患者的前瞻性数据库进行了回顾性分析。记录手术病例申请日期、并发症发生日期和HoLEP日期。收集术前、术中、术后特征并进行分析。结果:我们在这个时间段内从数据库中确定了918例患者,其中74例在等待HoLEP期间出现并发症。术前平均前列腺体积为122.7 ml。并发症包括8例心脏和37例泌尿系统事件。并发症与等待时间增加31.2天有关。心脏并发症患者等待113.5 d (p = 0.013)。在等待期间出现并发症的患者更有可能在手术后6个月内接受良性前列腺增生(BPH)药物治疗,依赖导管,并发生尿路感染(UTI)。并发症组术后90天并发症发生率为31.5%,无并发症组为20.4%。经历等待时间并发症的患者也更有可能延长术后导管时间和增加急诊室就诊次数。结论:有尿路感染史和导管依赖的患者在等待HoLEP时更容易出现并发症。等待时间并发症可显著延迟手术日期长达30天,并且术前出现并发症的患者术后更有可能出现进一步的并发症。需要努力加快和改善获得必要的BPH程序的机会。
Waiting for HoLEP-outcomes when complications arise in the preoperative period.
Purpose: Surgery for benign prostatic hyperplasia (BPH), including holmium laser enucleation of the prostate (HoLEP), is often considered to be elective, leading to many patients waiting for intervention. Wait times for HoLEP can vary on many factors, but the incidence and impact of complications in this preoperative waiting period are unknown. We sought to uncover the outcomes of HoLEP in patients who experienced a complication while waiting for surgery.
Methods: We performed a retrospective review of a prospectively maintained database of patients who underwent HoLEP at a high-volume center between January 2021 and August 2023. Date of surgical case request placement, date of complication occurrence, and date of HoLEP were recorded. Preoperative, intraoperative, and postoperative characteristics were collected and analyzed. Statistical analysis was performed with SPSS software with p < 0.05 denoting significance.
Results: We identified 918 patients in the database in this timeframe, with 74 experiencing a complication while waiting for HoLEP. Mean preoperative prostate volume was 122.7 ml. Complications included 8 cardiac and 37 urologic events. Complications were associated with a 31.2-day increase in wait time. Patients with cardiac complications waited 113.5 days (p = 0.013). Patients who had a complication while waiting were more likely to be on benign prostatic hyperplasia (BPH) medications, be catheter dependent, and have urinary tract infections (UTI) within 6 months of surgery. The 90-day postoperative complication rate was 31.5% in the complication group and 20.4% in the non-complication group. Patients who experienced a wait time complication were also more likely to have prolonged postoperative catheter duration and increased emergency room visits.
Conclusion: Patients with history of UTI and catheter dependence are more likely to experience a complication while waiting for HoLEP. Having a wait time complication can significantly delay surgery date by up to 30 days, and patients experiencing complication preoperatively are more likely to experience further complications postoperatively. Efforts are needed to expedite and improve access to necessary BPH procedures.
期刊介绍:
The WORLD JOURNAL OF UROLOGY conveys regularly the essential results of urological research and their practical and clinical relevance to a broad audience of urologists in research and clinical practice. In order to guarantee a balanced program, articles are published to reflect the developments in all fields of urology on an internationally advanced level. Each issue treats a main topic in review articles of invited international experts. Free papers are unrelated articles to the main topic.