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Safety and feasibility study of holmium laser enucleation of the prostate (HOLEP) on patients receiving dual antiplatelet therapy (DAPT)

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Abstract

Objective

To evaluate the safety and feasibility of Holmium laser enucleation of the prostate (HoLEP) in patients receiving dual antiplatelet therapy (DAPT).

Methods

From March 2013 to August 2016, we retrospectively analyzed 1124 benign prostatic hyperplasia (BPH) patients undergoing HoLEP and divided into four groups: 56 cases receiving DAPT therapy (group A); 72 patients treated with continuous single antiplatelet (AP) therapy (group B); 41 patients treated with single AP therapy but intermittent during preoperative time (group C) and 955 cases had no AP therapy (group D). Patients’ baseline characteristics, 1-year clinical outcomes, rates of postoperative bleeding and complications were presented in this study.

Results

All patients received successful operations and no severe postoperative complications occurred. Only one patient in Group D required transfusion. The enucleation time and catheterization time for the DAPT patients were the longest among four groups (p < 0.001, respectively). The overall complications rates within 30 days were 23.2% (13/56) in Group A, 27.8% (20/72) in Group B, 19.5% (8/41) in Group C, and 27.0% (258/955) in Group D, respectively (p = 0.678). By the 12 months, the international prostate symptom scores (IPSS), quality of life scores (QOL) and residual urine volume (RUV) in all groups have been significantly improved.

Conclusion

HoLEP in patients receiving DAPT after coronary artery stunting showed similar results to those achieved in patients receiving single AP therapy or non-AP therapy. It can be a good option, which the urologists can offer to those patients with symptomatic benign prostatic hyperplasia refractory to medical treatment.

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Abbreviations

BPH:

Benign prostatic hyperplasia

HoLEP:

Holmium laser enucleation of the prostate

TURP:

Transurethral resection of the prostate

PVP:

Photoselective vaporization of the prostate

CABG:

Coronary artery bypass grafts

DAPT:

Dual antiplatelet treatment

PSA:

Prostate-specific antigen

TRUS:

Transrectal ultrasonography

PVR:

Post-void residual urine

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Acknowledgements

We gratefully acknowledge the urologists making great contributions to the prostatic laser surgery, especially YiRan Huang and Gilling PJ.

Funding

The authors declare that they have no funding.

Author information

Author notes

  1. Jie Sun and An Shi authors contributed fully and equally to this work.

Authors and Affiliations

  1. Department of Urology, Renji Hospital affiliated to Shanghai Jiao Tong University, Medical School, No 160, PuJian Road, Pudong New District, Shanghai, 201200, China

    Jie Sun, An Shi, Zhen Tong & Wei Xue

Authors
  1. Jie Sun
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  2. An Shi
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  3. Zhen Tong
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  4. Wei Xue
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Contributions

SJ: Project development and manuscript writing. SA: Data collection and analysis, and manuscript writing. TZ: Data collection and management. XW: Project development and manuscript editing.

Corresponding author

Correspondence to Wei Xue.

Ethics declarations

Ethics statement

Institutional Review Board approval of Renji Hospital affiliated to Shanghai JiaoTong University, Medical school was obtained for the retrospective study and patient written informed consent was obtained.

Consent to publish

All of the details can be published and consent for publication was not required for this study.

Availability of data and materials

The datasets during the current study were available from the corresponding author on reasonable request.

Conflict of interest

The authors declare that they have no competing interests.

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Sun, J., Shi, A., Tong, Z. et al. Safety and feasibility study of holmium laser enucleation of the prostate (HOLEP) on patients receiving dual antiplatelet therapy (DAPT). World J Urol 36, 271–276 (2018). https://doi.org/10.1007/s00345-017-2129-y

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  • DOI: https://doi.org/10.1007/s00345-017-2129-y

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