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Comparison of Postoperative Outcomes of Trans-urethral Resection of the Prostate, Laser Vaporization, and Laser Enucleation: A Double Propensity Score Matched Analysis.
Ayoub, Christian Habib; Haber, Rachelle; Amine, Reem; Mikati, Diana; Mahfoud, Ziyad Riyad; El Hajj, Albert.
Afiliación
  • Ayoub CH; Department of Surgery, Division of Urology, American University of Beirut Medical Center, Beirut, Lebanon. Electronic address: Christian.habib.ayoub1@gmail.com.
  • Haber R; Department of Internal Medicine, Division of Endocrinology, American University of Beirut Medical Center, Beirut, Lebanon. Electronic address: ree16@mail.aub.edu.
  • Amine R; Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon. Electronic address: rha59@mail.aub.edu.
  • Mikati D; Salim El-Hoss Bioethics & Professionalism Program, American University of Beirut Medical Center, Beirut, Lebanon. Electronic address: dm29@aub.edu.lb.
  • Mahfoud ZR; Weill Cornell Medical College-Qatar, Doha, Qatar. Electronic address: zrm2001@qatar-med.cornell.edu.
  • El Hajj A; Department of Surgery, Division of Urology, American University of Beirut Medical Center, Beirut, Lebanon. Electronic address: ae67@aub.edu.lb.
Urology ; 177: 148-155, 2023 Jul.
Article en En | MEDLINE | ID: mdl-37182649
OBJECTIVE: To compare postoperative outcomes of 3 types of endourologic surgeries (trans-urethral resection of the prostate [TURP], laser vaporization [LVP], and laser enucleation [LEP]) for benign prostatic hypertrophy (BPH) treatment using the ACS-NSQIP database. METHODS: The ACS-NSQIP database was queried for men who underwent TURP, PVP, and LEP for treatment of BPH from 2011 till 2019. Demographics, clinical, operative characteristics, and 30-day outcomes were compared. Univariate and multivariate regression models were constructed. Propensity score matching was then performed as a sensitivity analysis. RESULTS: A total of 74,273 patients underwent endourologic surgeries for BPH, 65.4% had TURP, 28.6% PVP, and 5.9% LEP. Patients undergoing TURP were more likely to be older with higher ASA class, abnormal labs, and comorbidities (diabetic, congestive heart failure, and bleeding requiring transfusion) (P-value <.001). After adjusting for covariates and propensity score matching, LVP demonstrated shorter hospital stays, shorter operative times, less reoperation rates, decreased DVT/PE risk, with, however, higher odds of urinary tract infection and sepsis as compared to TURP (P-value<.028). Furthermore, LEP was found to have shorter hospital stays, longer operative times, and decreased odds of urinary tract infections and sepsis as compared to TURP (P-value<.006). CONCLUSION: LVP and LEP showed better surgical outcomes and characteristics as compared to TURP. Further research is needed to account for longer duration of follow-up and patient-specific urologic outcomes, such as prostate size, urinary incontinence, erectile dysfunction, and retrograde ejaculation.

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies Idioma: En Revista: Urology Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies Idioma: En Revista: Urology Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos