Risk Factors for Delayed Hematuria Following Photoselective Vaporization of the Prostate

Jackson, Robert E.; Casanova, Nathalie; Wallner, Lauren P.; Dunn, Rodney L.; Hedgepeth, Ryan C.; Faerber, Gary J.; Wei, John T.

doi:10.1016/j.juro.2013.03.070

Cited by 20 publications

(7 citation statements)

References 25 publications

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“…On the other hand, the use of 5-ARI and older age were protective factor. 19 In our study, we did not see the difference in those parameters between bleeding-related ER visits or not within 3 months. A long-term follow-up after five transurethral procedures is needed.…”

Section: Dovepresscontrasting

confidence: 65%

Risk Factors of Emergency Room Visits for Bleeding Complications Following Transurethral Procedures in the Treatment of Benign Prostatic Hyperplasia: A Retrospective Cohort Study

Teng

Shao

Hsu

et al. 2021

CIA

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Purpose Transurethral procedures, including transurethral resection of the prostate (TURP) and laser prostatectomy, are often linked to emergency room (ER) visits for postoperative bleeding. Although some studies have been conducted, the risk factors associated with these ER visits are not completely understood. This retrospective cohort study identified potential risk factors associated with ER visits for postoperative bleeding. Patients and Methods Preoperative assessment data and operational and postoperational parameters recorded at Chang Gung Memorial Hospital, Taiwan between December 2015 and January 2017 for patients who underwent elective transurethral procedures were analyzed to identify potential risk factors. The primary endpoint was ER visits for gross hematuria within three months following operation, and the secondary endpoint was ER visits for blood clot-induced urinary retention (clot retention) within three months following operation. Results A total of 665 patients who underwent elective transurethral procedures were enrolled. The transurethral procedures included monopolar transurethral resection of the prostate (M-TURP), bipolar TURP (B-TURP), greenlight photoselective vaporization of the prostate (PVP), thulium laser enucleation of the prostate (ThuLEP) and thulium laser transurethral vaporesection of the prostate (ThuVARP). Regarding ER visits for clot retention within three months, multivariable logistic regression revealed significantly lower rates of clot retention in patients who received B-TURP than in those who underwent ThuVARP (AOR, 0.18; 95% confidence interval [CI], 0.04–0.82, p = 0.027). Moreover, significantly higher clot retention was observed in patients who underwent two or more rounds of manual irrigation (AOR, 9.51; 95% CI, 1.66–54.43, p = 0.011). Conclusion Multiple manual irrigations shortly after operation can be considered a novel predictor of postoperative clot retention-related ER visits. Among the transurethral procedures, ThuVARP was associated with a higher risk of clot retention-related ER visits than was B-TURP.

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Section: Dovepresscontrasting

confidence: 65%

Risk Factors of Emergency Room Visits for Bleeding Complications Following Transurethral Procedures in the Treatment of Benign Prostatic Hyperplasia: A Retrospective Cohort Study

Teng

Shao

Hsu

et al. 2021

CIA

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“…Haemostatic properties have also been shown in patients with an increased haemorrhage risk (anticoagulation/ antiplatelets therapy, bleeding disorders) [20,21]; however, the retrospective nature of many studies and the inclusion of prostate sizes only between 50 mL and 110 mL make it difficult to come to strong conclusions [22]. Some studies have investigated factors potentially linked to postoperative bleeding, showing a higher rate in patients with larger prostate size [17], and those on anticoagulation [23] or who underwent multiple manual irrigations shortly after operation [24]. In this study we report our analysis of the risk of bleeding after discharge and its predictive factors in patients undergoing ThuLEP.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors Predicting Bleeding After Discharge Requiring Readmission After Thulium Laser Enucleation of the Prostate (ThuLEP)

Perri,

Pacchetti,

Morini

et al. 2023

Soc Int Urol J

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ObjectivesPostoperative haematuria is a feared complication following prostate enucleation, and it may occur even weeks after discharge. We evaluated the risk of bleeding after discharge and its predictive factors in patients who underwent Thulium laser enucleation of the prostate (ThuLEP).MethodsBetween January 2015 and December 2018, patients with surgical indication for benign prostatic hyperplasia underwent ThuLEP in 4 urology departments. All procedures were performed by experienced urologists. Postoperative haematuria was defined as macroscopic haematuria occurring 7 days after discharge. Readmission rate due to macroscopic haematuria was assessed. Logistic regression models tested for predictors of postoperative bleeding requiring readmission.ResultsOverall, 748 patients were included, and 52 (6.9%) of them were readmitted after discharge because of macroscopic haematuria. No cases of deep venous thrombosis or pulmonary embolism were diagnosed. Mean length of stay for surgical treatment was 2.1 days, and mean hospitalization for readmission was 5.6 days. None of the readmitted patients required reintervention, while 46.1% of them required blood transfusions. Diabetes mellitus (P < 0.05), a long bridge of oral anticoagulant drugs with low molecular weight heparin (LMWH) (P < 0.05) and history of constipation (P < 0.05) were significant predictors of readmission after discharge due to macroscopic haematuria.ConclusionsPatients with a clinical history of diabetes mellitus or constipation and patients who undergo a long bridge of oral anticoagulant therapy with LMWH are at higher risk of bleeding requiring readmission after ThuLEP.

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“…(7) Chart review studies have suggested that risk factors for early postoperative gross hematuria following endoscopic prostate resection or vaporisation may include large prostate size, use of anticoagulation, and younger age, and the benefit of 5ARIs during this initial period is inconsistent. (8,9) We feel that the evidence for gross hematuria reduction in operation-naïve prostates(10) and during TURP(5) should not be automatically extrapolated to the post-TURP period. Given the lack of evidence supporting the use of 5ARIs after TURP, and their potential adverse effects(11) their use should be further evaluated in clinical trials specific to this clinical scenario.…”

Section: Discussionmentioning

confidence: 99%

Do 5 alpha reductase inhibitors decrease the risk of recurrent gross hematuria in patients who have had a transurethral prostatectomy?

Welk

Reid²,

Ordon³

et al. 2021

CUAJ

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Risk Factors for Delayed Hematuria Following Photoselective Vaporization of the Prostate

Cited by 20 publications

References 25 publications

Risk Factors of Emergency Room Visits for Bleeding Complications Following Transurethral Procedures in the Treatment of Benign Prostatic Hyperplasia: A Retrospective Cohort Study

Risk Factors of Emergency Room Visits for Bleeding Complications Following Transurethral Procedures in the Treatment of Benign Prostatic Hyperplasia: A Retrospective Cohort Study

Prognostic Factors Predicting Bleeding After Discharge Requiring Readmission After Thulium Laser Enucleation of the Prostate (ThuLEP)

Do 5 alpha reductase inhibitors decrease the risk of recurrent gross hematuria in patients who have had a transurethral prostatectomy?

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