Holmium laser transurethral incision of the prostate: Can prostate size predict the long-term outcome?
Notice bibliographique
Résumé
INTRODUCTION: We determine the impact of prostate size on the long-term outcome of holmium laser transurethral incision of the prostate (Ho-TUIP) for bladder outlet obstruction (BOO) secondary to benign prostate enlargement (BPE). METHODS: A retrospective review of prospectively collected data was performed for patients undergoing Ho-TUIP by a single surgeon for patients presenting with lower urinary tract symptoms (LUTS) secondary to BOO. Patients were stratified into 2 groups: Group 1 included patients with prostate ≤30 cc and Group 2 included patients with prostate >30 cc. Demographic, operative and follow-up data were recorded and analyzed. In addition, intraoperative and long-term adverse events were included. RESULTS: In total, 82 patients underwent surgery between March 1998 and March 2013, including 9 (11%) reoperated patients. Only prostate size independently predicted reoperation after Ho-TUIP (adjusted odds ratio [aOR], 95% confidence interval [CI] 7.12 [2.92-9.14], p = 0.01). The receiver operating characteristic (ROC) analysis showed an optimal cutoff value of prostate volume of 29 cc to characterize long-term reoperation after TUIP, with area under the curve (AUC) of 0.96, sensitivity of 89.7 and specificity of 88.9. Group 1 included 51 patients and Group 2 included 31 patients. The international prostate symptoms score (IPSS) and peak flow rate (Qmax) significantly improved in both groups at different follow-up points. At the 12-month follow-up, the percent change in IPSS and Qmax were comparable between both groups. However, after 12 months, the degree of improvement in all voiding parameters was significantly higher in Group 1 (p < 0.001 at all points of follow-up). After a median follow-up of 5.3 years (range: 1-13), both groups had comparable early and late adverse events with significantly higher reoperation rate in Group 2 (3.9% vs. 22.6%, p = 0.02). Overall retrograde ejaculation was detected in 25.6% of sexually active men and it was comparable between both groups (23.5% vs. 29%, p = 0.61). On multivariable analysis, patients with prostate volume >30 cc were associated with significantly higher reoperation for BOO (aOR 95% CI 5.72 [2.83-8.14], p = 0.02), significantly higher IPSS (aOR 1.72), higher quality of life index (aOR 1.72) and lower Qmax (aOR 0.28). CONCLUSION: Ho-TUIP is a durable, safe and efficient treatment of BOO secondary to a small-sized prostate. The long-term outcome could be improved and the re-operation rate could be minimized with appropriate selection of cases, with prostate glands no bigger than 30 cc.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».