Outcomes after laser enucleation of the prostate with and without significant storage symptoms.

IF 3.7 2区 医学 Q1 UROLOGY & NEPHROLOGY BJU International Pub Date : 2024-08-07 DOI:10.1111/bju.16495
Cristina Cano Garcia, Maria Welte, Maximilian Filzmayer, Pia Bongardt, Fiona Schlesinger, Ivan Nikolov, Zhe Tian, Pierre I Karakiewicz, Luis A Kluth, Philipp Mandel, Felix K H Chun, Marina Kosiba, Andreas Becker
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Abstract

Objective: To test for differences in recovery of lower urinary tract symptoms (LUTS) between patients with storage-positive vs -negative symptoms after laser enucleation of the prostate (LEP).

Patients and methods: Consecutive storage-positive (severe storage symptoms, International Prostate Symptom Score [IPSS] storage subscore >8) vs storage-negative patients treated with LEP (November 2017-September 2022) within our tertiary-care database were identified. Mixed linear models tested for changes in IPSS and quality of life (QoL) at 1, 3 and 12 months after LEP. Multiple linear regression models tested for LUTS and QoL recovery risk factors at 1, 3 and 12 months.

Results: Of 291 study patients, 180 (62%) had storage-positive symptoms. There were no differences between storage-positive and -negative patients in mean adjusted total IPSS, IPSS-storage, IPSS-voiding and QoL at 12 months after LEP. In multiple linear regression models, storage-positive status was identified as a risk factor for higher IPSS at 1 month (β coefficient 2.98, P = 0.004) and 3 months (β coefficient 2.24, P = 0.04), as well as for more unfavourable QoL at 1 month (β coefficient 0.74, P = 0.006) and 3 months (β coefficient 0.73, P = 0.004) after LEP. Conversely, at 12 months there were no differences between storage-positive vs -negative patients.

Conclusion: Storage-positive patients appear to experience similar long-term benefits from LEP compared to storage-negative patients. However, significant storage symptoms are associated with higher total IPSS and less favourable QoL at 1 and 3 months after LEP. These findings advocate for the consideration of LEP also in storage-positive cases with the need for thorough patient education especially in the initial post-LEP period.

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前列腺激光去核术后有无明显贮存症状的结果。
目的检验前列腺激光去核术(LEP)后储尿阳性患者与储尿阴性患者在下尿路症状(LUTS)恢复方面的差异:在我们的三级医疗数据库中,确定了连续的储尿阳性(严重储尿症状,国际前列腺症状评分[IPSS]储尿子分值>8)与储尿阴性患者接受LEP治疗的情况(2017年11月至2022年9月)。混合线性模型检测了LEP后1、3和12个月时IPSS和生活质量(QoL)的变化。多元线性回归模型检测了 1、3 和 12 个月后 LUTS 和 QoL 恢复的风险因素:在 291 名研究患者中,180 人(62%)有储藏阳性症状。LEP 术后 12 个月时,在调整后的总 IPSS、IPSS-储量、IPSS-排空和 QoL 平均值方面,储量阳性和阴性患者之间没有差异。在多元线性回归模型中,储量阳性是 LEP 后 1 个月(β 系数 2.98,P = 0.004)和 3 个月(β 系数 2.24,P = 0.04)IPSS 较高以及 1 个月(β 系数 0.74,P = 0.006)和 3 个月(β 系数 0.73,P = 0.004)QoL 较差的危险因素。相反,在 12 个月时,储存阳性患者与储存阴性患者之间没有差异:结论:与蓄积阴性患者相比,蓄积阳性患者似乎从 LEP 中获得了相似的长期益处。然而,在 LEP 术后 1 个月和 3 个月,明显的蓄积症状与较高的总 IPSS 值和较差的 QoL 值相关。这些研究结果主张对储藏阳性病例也应考虑 LEP,同时需要对患者进行全面的教育,尤其是在 LEP 后的初期。
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来源期刊
BJU International
BJU International 医学-泌尿学与肾脏学
CiteScore
9.10
自引率
4.40%
发文量
262
审稿时长
1 months
期刊介绍: BJUI is one of the most highly respected medical journals in the world, with a truly international range of published papers and appeal. Every issue gives invaluable practical information in the form of original articles, reviews, comments, surgical education articles, and translational science articles in the field of urology. BJUI employs topical sections, and is in full colour, making it easier to browse or search for something specific.
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