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Prospective assessment of perioperative course in 2648 patients after surgical treatment of benign prostatic obstruction

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Abstract

Purpose

TUR-prostate (TUR-P) is considered the reference method for surgical treatment of benign prostatic obstruction (BPO); Greenlight laser photoselective vaporization (PVP) and thulium laser vapoenucleation (ThuVEP) have also been established as treatments of BPO. Objective of this prospective observation was to compare a large numbers of patients treated in everyday routine.

Methods

This prospective multicentre data collection assesses morbidity and perioperative course of consecutive men treated with BPO-related transurethral surgery between 2011 and 2014 in a German metropolis area with TUR-P, PVP or ThuVEP.

Results

Two thousand six hundred and forty-eight patients have been treated in the time period. All treatment options achieved immediate improvement of voiding parameters. Multivariate analyses proved shorter hospital stay after laser treatments as compared to resection (p < 0.001). In terms of hospital stay, the advantage of ThuVEP compared to TUR-P increased with prostate volume (p < 0.001). Patients with ongoing anticoagulation or bridging had prolonged hospital stay (p < 0.001). Overall adverse events were least frequent in PVP (p 0.016), as were Clavien 3b events (p < 0.001).

Conclusions

Surgical treatment of BPO is effective and safe independent of the surgical procedure. Volume reduction is most effective in ThuVEP; PVP has the lowest rate of severe complications. Laser treatment is associated with shorter hospital stay. Surgery under ongoing anticoagulation prolonged the post-operative hospital stay.

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Authors’ contribution

T. Bach developed the project and was involved in data management, data analysis and manuscript writing. F. Wölbling was involved in data collection and management and data analysis. A.J. Gross, C. Netsch, S. Tauber, T. Pottek and C. Wülfing were involved in manuscript editing. C. Brunken was involved in manuscript editing and data analysis.

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Author notes

    Authors and Affiliations

    1. Department of Urology, Asklepios Hospital Harburg, Eissendorfer Pferdeweg 52, 21075, Hamburg, Germany

      Thorsten Bach & Felix Wölbling

    2. Department of Urology, Asklepios Hospital Barmbek, Hamburg, Germany

      Andreas J. Gross & C. Netsch

    3. Department of Urology, Asklepios Hospital St. Georg, Hamburg, Germany

      S. Tauber & Claus Brunken

    4. Department of Urology, Asklepios Westklinkum Rissen, Hamburg, Germany

      Tobias Pottek

    5. Department of Urology, Asklepios Hospital Altona, Hamburg, Germany

      Christian Wülfing

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    1. Thorsten Bach
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    3. Andreas J. Gross
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    Corresponding author

    Correspondence to Thorsten Bach.

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    Ethical approval

    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

    Additional information

    Thorsten Bach and Felix Wölbling have contributed equally to this research.

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    Bach, T., Wölbling, F., Gross, A.J. et al. Prospective assessment of perioperative course in 2648 patients after surgical treatment of benign prostatic obstruction. World J Urol 35, 285–292 (2017). https://doi.org/10.1007/s00345-016-1866-7

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    • DOI: https://doi.org/10.1007/s00345-016-1866-7

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