Photoselective vaporization has comparative efficacy and safety among high-risk benign prostate hyperplasia patients on or off systematic anticoagulation: a meta-analysis

Zheng, Xiaonan; Qiu, Yuxuan; Qiu, Shi; Tang, Liansha; Nong, Kailei; Han, Xin; Li, Min; Quan, Liuliu; Yang, Lu; Wei, Qiang

doi:10.1007/s00345-018-2530-1

Cited by 14 publications

(8 citation statements)

References 32 publications

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“…BPH is the most common disease in elderly men. When the disease progresses to a certain stage, patients often suffer from chronic urinary retention due to obstruction of lower urinary tract, causing lower abdominal pain, repeated urinary tract infection, hematuria, which easily lead to serious coplications such as bladder dysfunction, renal insufficiency, electrolyte disturbance, etc., and poses a serious threat to the health of elderly men ( 11 – 13 ). Although BPH high-risk patients have obvious symptoms of lower urinary tract obstruction and their quality of life declines, their tolerance to anesthesia and surgical intervention is poor due to physical factors.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Prostatic Artery Embolization in the Treatment of High Risk Benign Prostatic Hyperplasia and its Influence on Postoperative Life Quality of Patients

et al. 2022

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ObjectiveTo evaluate the efficacy, safety and postoperative quality of life of high risk benign prostatic hyperplasia (BPH) patients treated with prostatic artery embolization.Methods34 patients with high-risk BPH were selectedfrom January 2020 to June 2021 in our hospital. All patients were treated with prostatic artery embolization. The changes of international prostate symptom score (IPSS), prostate volume (PV), remaining urine (RU), maximum urine flow rate (Qmax), quality of life scale -74(GQOLI-74), time to sleep without disturbance (HUS) judgment, self-rating anxiety scale (SAS) score and self-rating depression scale (SDS) were compared before operation, 1 month and 6 months after operation.ResultsProstatic artery embolization was successful in all 34 patients, including unilateral embolization in 15 patients and bilateral embolization in 19 patients. No severe complications occurred in the postoperative patients. The IPSS, PV and RU levels of the patient one month and six months after surgery were lower than those before surgery, while the Qmax level was higher than that before surgery. Besides, the IPSS, PV and RU levels six months after surgery were significantly lower than those one month after surgery, and the Qmax level was significantly higher than that one month after surgery (p < 0.05). The GQOLI-74 score six months after surgery was significantly higher than that before surgery (p < 0.05). The HUS of the patient six months after surgery was significantly increased, and the SAS and SDS scores were significantly decreased as compared with those before surgery (p < 0.05).ConclusionFor high-risk patients with BPH, prostate embolization is an effective and safe method, which can significantly improve the quality of life of patients after surgery and has good application prospects.

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Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Prostatic Artery Embolization in the Treatment of High Risk Benign Prostatic Hyperplasia and its Influence on Postoperative Life Quality of Patients

et al. 2022

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“…þ Lower rate of blood transfusions compared to TURP [8,9] þ Short hospitalization/day surgery [40,41] þ Short catheterization time [56 & ] þ May be offered to patients undergoing antithrombotic therapy [61] -Elevated retreatment rates in larger glands [42] 5 þ Day surgery possible [45,46] þ Local anesthesia [44,50,51] þ Short catheterization time [44] þ Less bleeding [44] -Paucity of long-term data [42,61] Surgical treatment options for BPO Deyirmendjian et al…”

Section: Transurethral Incision Of the Prostate (Tuip)mentioning

confidence: 99%

Surgical treatment options for benign prostatic obstruction: beyond prostate volume

Deyirmendjian

Chughtai

Zorn

et al. 2022

Current Opinion in Urology

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Purpose of reviewMany surgical treatment options are available for patients who present with benign prostatic obstruction (BPO). This article reviews the current treatment options available and distinguishes them based on five clinical considerations: antithrombotic therapy, sexual function preservation, ambulatory procedures, anesthesia-related risks and duration of catheterization. Recent findingsA comprehensive review of the literature was performed on 10 BPO procedures. Laser enucleation of the prostate (LEP), bipolar plasma transurethral vaporization of the prostate and photoselective vaporization (PVP) of the prostate reduces the risk of bleeding, which is recommended for anticoagulated men. Ejaculatory function is more likely to be preserved following transurethral incision of the prostate, Rezu ¯m, Aquablation, UroLift and iTind. Same-day discharge is possible for LEP, PVP and prostatic arterial embolization (PAE). For patients with high anesthesia-related risks, procedures compatible with local anesthesia (UroLift, Rezu ¯m, iTind and PAE) should be favored. Catheterization duration is shorter with UroLift, PVP and LEP. SummaryBPO treatment options are growing rapidly. The optimal procedure for a given patient is based on factors such as associated risks, recovery and expected outcomes. Besides prostate volume, the clinical considerations in the present article can help elucidate the best surgical BPO treatment option for each patient based on their values, preferences, and risk tolerance.

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“…Furthermore, only one patient in the antithrombotic medication group received a blood transfusion. The only difference was found for catheterization time, which was 0.54 days longer for patients on antithrombotic medication [ 2 ▪ ]. The study outlines the good hemostatic capabilities of the greenlight laser and its utility in treating patients at high risk of bleeding.…”

Section: Patients Taking Antithrombotic Medicationmentioning

confidence: 99%

Electrosurgery or laser for benign prostatic enlargement: trumpcard or pitfalls

Pallauf

Herrmann

Oswald

et al. 2021

Current Opinion in Urology

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Purpose of review To summarize and comment on publications of the last 2 years in the field of endoscopic surgery for benign prostatic enlargement, focusing on similarities and differences of laser and electrosurgery. Recent findings Because of good hemostasis and safety, invasive endoscopic surgery has evolved to a choice of treatment for vulnerable patients with ongoing antithrombotic medication and in same-day surgery. Recent publications show a good perioperative course and no deterioration in the postoperative outcome. Furthermore, alterations to the original surgical techniques of resection, enucleation, and vaporization have increased the preservation rate for antegrade ejaculation, advancing them to an appealing choice of treatment for sexually active men. Favorable outcomes can be achieved in both laser and electrosurgery. Only the choice of the surgical technique determines the outcome. Summary Various invasive endoscopic surgical techniques are available, offering different advantages and disadvantages for the patient. All of them can be performed with laser and electrosurgery. Therefore, focusing on the proper choice of surgical technique instead of the energy source will guarantee the patient to benefit most.

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Photoselective vaporization has comparative efficacy and safety among high-risk benign prostate hyperplasia patients on or off systematic anticoagulation: a meta-analysis

Cited by 14 publications

References 32 publications

Efficacy and Safety of Prostatic Artery Embolization in the Treatment of High Risk Benign Prostatic Hyperplasia and its Influence on Postoperative Life Quality of Patients

Efficacy and Safety of Prostatic Artery Embolization in the Treatment of High Risk Benign Prostatic Hyperplasia and its Influence on Postoperative Life Quality of Patients

Surgical treatment options for benign prostatic obstruction: beyond prostate volume

Electrosurgery or laser for benign prostatic enlargement: trumpcard or pitfalls

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