Presentation Authors: Engin Kaya*, Eymen Gazel, Serdar Yalcın, Ankara, Turkey, Theodoros Tokas, Tirol, Austria, Tahsin Batuhan Aydogan, Halil Cagrı Aybal, Lutfi Tunc, Ankara, Turkey
Introduction: To evaluate the effect of prostate tissue density(PTD) on perioperative outcomes of the HoLEP procedure.
Methods: Two hundred fourteen patients were enrolled in our study who underwent HoLEP between December 2016 and August 2018. PTD is a continuous variable and dichotomized via the median split (1g/mL) procedure to form high and low groups for the comparison of the perioperative parameters. The group 1(PTD < 1 g/mL) had 100 patients and the group 2(PTDâ‰¥1 g/mL) had 114 patients. Procedures were performed in patients with LUTS and inadequate response to medical therapy, maximum urinary flow rate (Qmax) < 15 ml/s, as well as gross hematuria, recurrent urinary tract infections, postvoid residual (PVR) volume >150 ml and acute urinary retention due to BPH. Patients with neurogenic bladder, confirmed prostate or bladder cancer, urethral stricture, patients using dutasterid and previous prostate surgeries were excluded. Enucleation time(ET), morcellation time(MT), total operation time(TOT), total laser energy(TLE), efficiency of laser (EL), efficiency of enucleation(EE), efficiency of morcellation(ME), enucleation rate(ER), enuclated tissue weight(ETW) were recorded.
Results: The mean ages of the group 1 and group 2 were 61.36Â±5.92 and 63.1Â±7.52 years, respectively. TOT, ET, EE, ETW were not significant between the two groups. However, the MT was longer in group 2 with than in group 1(11.27Â±8.57 min&7.22Â±5.46 min, p=0.0001). Further, EM was higher in group 1 than in group 2 (9.81Â±5.61g/min&7.45Â±4.14 g/min, p=0.0003).The EL and TLE were similar in both groups (Table 1). PTD positively correlated with MT (rho=0.272, p=0.0005) and negatively correlated with EM (rho=-0.315, p=0.0001). No correlations were identified between the PTD and EL or EE (Figure 1-2).
Conclusions: PTD is a factor that influences the HoLEP on perioperative outcomes. The PTD particularly affects the morcellation phase of the surgery. Patients with higher PTD will have a longer duration of MT and lesser EM. Future studies with the use of different imaging methods will give insight into the duration and difficulty of the HoLEP.