Ahmed M Elshal, Fady K Ghobrial, Mahmoud Laymon, Mohamed Elegeezy, Ahmed R El-Nahas
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引用次数: 0
Abstract
Objectives: Safety of GreenLight™ laser prostatectomy (GL-LP) in patients with ongoing blood thinners has been proven. Yet, the possibility of drug manipulation makes it a less challenging situation compared to treating patients with uncorrectable bleeding tendency. Herein, we aim at evaluating the outcomes of XPS™-180 W GL-LP for treatment of BPH in patients who had uncorrectable bleeding tendency due to hepatic dysfunction.
Methods: A prospectively maintained database for all patients who underwent GL-LP for symptomatic BPH was reviewed. Patients were divided into two groups based on the degree of hepatic dysfunction using Fib-4 index: Group 1 (indexed patients; low-risk Fib-4) and Group 2 (non-indexed patients; intermediate-high-risk Fib-4) included those who had chronic liver disease associated with either thrombocytopenia and/or hypoprothrombinemia. Primary outcome was the difference in perioperative bleeding complications between the two groups. Other outcome measures included all perioperative findings and complications as well-functional outcome measures.
Results: The study included 140 patients (93 indexed patients and 47 non-indexed). There were no significant differences between both groups in operative time, laser time and energy, auxiliary procedures, catheter time, hospital stay, and hemoglobin deficit. The need for blood transfusion was significantly more in group 2 (two patients (4.3%) versus no patients in group 1, P = 0.045). Perioperative and late postoperative complications were comparable for both groups (P = 0.634 and 0.858, respectively). There were no significant differences in the postoperative uroflow, symptoms score, and PSA reduction between the two groups (P = 0.57, 0.87, and 0.05, respectively).
Conclusions: XPS™-180 W GL-LP is a safe and effective technique for treatment of BPH in patients with uncorrectable bleeding tendency due to hepatic dysfunction.
期刊介绍：
The Arab Journal of Urology is a peer-reviewed journal that strives to provide a high standard of research and clinical material to the widest possible urological community worldwide. The journal encompasses all aspects of urology including: urological oncology, urological reconstructive surgery, urodynamics, female urology, pediatric urology, endourology, transplantation, erectile dysfunction, and urinary infections and inflammations. The journal provides reviews, original articles, editorials, surgical techniques, cases reports and correspondence. Urologists, oncologists, pathologists, radiologists and scientists are invited to submit their contributions to make the Arab Journal of Urology a viable international forum for the practical, timely and state-of-the-art clinical urology and basic urological research.
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