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Benign prostatic hyperplasia surgical scoring (BPHSS): an novel scoring system for the perioperative outcomes of holmium laser enucleation of the prostate

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Abstract

To develop a standardized scoring system, the BPH surgical scoring (BPHSS) system, to quantify the ability to predict the perioperative outcomes resulting from an enlarged prostate. There are two parts included in this study: the retrospective observational study (875 patients treated with holmium laser enucleation of the prostate, HoLEP) and the prospective observational study (111 patient underwent HoLEP). All the outcome data included the following: the basic patient preoperative characteristics, operation time (OT), pre- and post- surgery hemoglobin decrease, Na+ variation, hospital stay duration, duration of bladder irrigation, catheterization time, and hospitalization time. The BPHSS, consisting of prostatic volume (PV), prostate-specific antigen (PSA), bladder stones, intravesical prostatic protrusion (IPP), and metabolic syndrome (MetS), was observed regarding the perioperative outcomes. In the retrospective study, patients in high BPHSS group (6–8 points) showed significant increase in the OT (74.61, 95%CI = 16.98–327.84, P < 0.001), hemochrome reduction (416.50, 95%CI = 35.48–4889.88, P < 0.001), hospital stay (1.80, 95%CI = 1.35–2.41, P < 0.001), and bladder irrigation duration (4.04, 95%CI = 1.35–12.10, P = 0.013) compared with the low BPHSS group (0–2 points). In the prospective study, there also existed significant differences between the three scoring grades (P < 0.01) in OT, hemochrome decrease, and the hospital stay. The BPHSS is suitable to predict the perioperative outcomes in patients undergoing HoLEP. It may help urologist to prepare more before surgery to treat the enlarged prostates. Further studies are needed to validate this scoring system in BPH patients in multiple centers.

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Abbreviations

BPH :

benign prostatic hyperplasia

BPHSS :

BPH surgical scoring

HoLEP :

holmium laser enucleation of the prostate

OT :

operation time

PV :

prostatic volume

PSA :

prostate-specific antigen

IPP :

intravesical prostatic protrusion

MetS :

metabolic syndrome

TUEP :

transurethral enucleation of the prostate

TURP :

transurethral resection of the prostate

PVR :

postvoid residual

ROC :

receiver operating characteristic

EAU :

European Association of Urology

AUC :

area under the curve

OAB :

overactive bladder

PAE :

prostatic arterial embolization

5ARI :

5-α reductase inhibitors

LUTS :

lower urinary tract symptoms

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Funding

This research was supported by Shanghai Pudong new area health and family planning project (NO. PW2013D-3), key disciplines group construction project of Pudong Health Bureau of Shanghai (PWZxq2014-11), Program for Outstanding Medical Academic Leader, and Speciality Construction Project of Pudong Health, and Family Commission of Shanghai (NO. PWZz2013-16).

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Author notes

  1. Huan Xu and Zhikang Cai contributed equally to this work.

Authors and Affiliations

  1. Department of Urology, Shanghai Ninth People’s Hospital, Shanghai Jiao tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China

    Huan Xu, Zhikang Cai, Yanbo Chen, Meng Gu, Qi Chen & Zhong Wang

Authors
  1. Huan Xu
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  2. Zhikang Cai
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  3. Yanbo Chen
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  4. Meng Gu
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  5. Qi Chen
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  6. Zhong Wang
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Corresponding authors

Correspondence to Qi Chen or Zhong Wang.

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Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

Ethics approval and consent to participate: ethical approval of the patients were obtained in our study from Shanghai 9th People’s Hospital Ethics Committee.

Informed consent

Written informed consent was obtained from each patient.

Additional information

Whether the paper is based on a previous communication to a society or meeting: No

Trial registration: ChiCTR-OOC-16008455

Electronic supplementary material

Supplemental Figure 1

The flow diagram of this trial. (GIF 180 kb)

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Supplemental Table 1

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Xu, H., Cai, Z., Chen, Y. et al. Benign prostatic hyperplasia surgical scoring (BPHSS): an novel scoring system for the perioperative outcomes of holmium laser enucleation of the prostate. Lasers Med Sci 33, 589–595 (2018). https://doi.org/10.1007/s10103-017-2425-1

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  • DOI: https://doi.org/10.1007/s10103-017-2425-1

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