Evaluating the effects of preoperative treatment with 5-alpha reductase inhibitors in holmium laser enucleation of the prostate

R. Bultó Gonzalvo, M. Bernardello Ureta, J. Cervera Alcaide, M. Sanchez Rodriguez, M. Franco, R. Freixa Sala, J. Areal Calama, F. Agreda Castañeda
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Abstract

Introduction and aim

Patients treated with HoLEP are frequently treated with previous treatments, including 5-alpha-reductase inhibitors (5-ARIs). We investigated the impact of pretreatment with 5-ARIs on perioperative and immediate postoperative parameters in patients treated with HoLEP.

Material and methods

A retrospective study was performed using a prospectively collected database including all patients treated with HoLEP at our center between January 2017 and January 2023. The resected tissue weight, enucleation and morcellation efficiency (enucleation weight/time and morcellation weight/ time), postoperative complications, hospital stay and hemoglobin drop have been analyzed.

Results

A total of 327 patients were included. Of these, 173 (52.9%) were treated with 5-ARIs. No differences were found among the perioperative parameters investigated to determine efficiency. No differences were observed in peri- or postoperative complications, hospital stay or hemoglobin drop.

Conclusions

Therapy with 5-ARIs had no impact on the immediate postoperative outcomes of patients treated with HoLEP. In our cohort, we observed that the use of 5-ARIs did not affect surgical efficiency, enucleation or morcellation. Further multicenter studies will be necessary to validate these findings.

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评估在前列腺钬激光去核术中使用 5-α 还原酶抑制剂进行术前治疗的效果
引言和目的接受HoLEP治疗的患者通常会接受包括5-α-还原酶抑制剂(5-ARIs)在内的既往治疗。我们研究了5-ARIs预处理对HoLEP患者围手术期和术后即刻参数的影响。材料和方法使用前瞻性收集的数据库进行了一项回顾性研究,该数据库包括2017年1月至2023年1月期间在本中心接受HoLEP治疗的所有患者。对切除组织重量、去核和去骨效率(去核重量/时间和去骨重量/时间)、术后并发症、住院时间和血红蛋白下降进行了分析。结果共纳入 327 例患者,其中 173 例(52.9%)接受了 5-ARIs 治疗。为确定疗效而进行的围手术期参数调查未发现差异。在围手术期或术后并发症、住院时间或血红蛋白下降方面均未观察到差异。在我们的队列中,我们观察到使用 5-ARIs 不会影响手术效率、去核或切除。有必要进一步开展多中心研究来验证这些发现。
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