Abstract：
PURPOSE:Holmium laser enucleation of the prostate (HoLEP) has become a popular alternative to TURP for desobstructive prostate surgery. The prevalence of incidental prostate cancer (iPCa) during surgery varies depending on many preoperative factors. To evaluate whether the surgical procedure itself (HoLEP vs. TURP) influences iPCa detection, we performed a case-by-case matched-pair analysis. METHODS:Preoperative patient age, total PSA, and prostate volume were used as matching criteria. Descriptive statistics were used to confirm matching quality. Parameters were analyzed by Fisher's exact test and T test or Mann-Whitney U test for dichotomous and continuous variables, respectively. Uni- and multivariate logistic regression analyses were performed to identify predictors for iPCa detection. RESULTS:60 out of 136 patients after HoLEP and 60 out of 1220 patients after bipolar TURP (bTURP) could be included. Mean patient age was 71.5 and 70.3 years in the HoLEP and bTURP group, respectively. Median preoperative total PSA was 4.42 ng/ml for HoLEP and 4.33 ng/ml for bTURP patients. Median preoperative prostate volume was 75.0 cc in both groups. Mean percentage of tissue removed by HoLEP and bTURP was 63.5 and 49.5% (p < 0.001), respectively. IPCa was found in 23.3% of HoLEP specimens compared to 8.3% in bTURP (p = 0.043). PSA density was the only independent predictor for iPCa detection. CONCLUSIONS:In this first matched-pair analysis, HoLEP provides a significantly higher iPCa detection rate than bTURP. This might be a result of a more efficient tissue removal during HoLEP. PSA density was the only independent risk factor for iPCa.
journal_name
World J Uroljournal_title
World journal of urologyauthors
Rosenhammer B,Lausenmeyer EM,Mayr R,Burger M,Eichelberg Cdoi
10.1007/s00345-018-2353-0subject
Has Abstractpub_date
2018-12-01 00:00:00pages
2035-2041issue
12eissn
0724-4983issn
1433-8726pii
10.1007/s00345-018-2353-0journal_volume
36pub_type
杂志文章abstract：:The treatment of clinically locally advanced prostate cancer (cT3-4) is subject to controversies. Patients with lymph node metastases as well as patients with overstaged localized and thus curable disease fall into this category. Radical prostatectomy, external beam radiotherapy and early or deferred hormonal therapy ...
journal_title：World journal of urology
pub_type： 杂志文章,评审
doi：10.1007/s00345-007-0158-7
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journal_title：World journal of urology
pub_type： 杂志文章
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更新日期：1998-01-01 00:00:00
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journal_title：World journal of urology
pub_type： 杂志文章,多中心研究
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abstract：PURPOSE:Patients presenting with prostate gland sizes greater than 200 cc pose a unique surgical challenge to both patients and surgeons. The objective of this study is to critically assess the efficacy and risks associated with performing holmium laser enucleation of the prostate (HoLEP) on glands ≥ 200 cc. MATERIALS...
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journal_title：World journal of urology
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journal_title：World journal of urology
pub_type： 杂志文章,评审
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journal_title：World journal of urology
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journal_title：World journal of urology
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pub_type： 临床试验,杂志文章
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journal_title：World journal of urology
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更新日期：2011-06-01 00:00:00
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journal_title：World journal of urology
pub_type： 杂志文章,评审
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journal_title：World journal of urology
pub_type： 杂志文章,评审
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journal_title：World journal of urology
pub_type： 杂志文章,多中心研究
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journal_title：World journal of urology
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journal_title：World journal of urology
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journal_title：World journal of urology
pub_type： 杂志文章,评审
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journal_title：World journal of urology
pub_type： 杂志文章
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更新日期：2003-05-01 00:00:00
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journal_title：World journal of urology
pub_type： 杂志文章,多中心研究
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更新日期：2014-06-01 00:00:00
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更新日期：2020-06-26 00:00:00
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journal_title：World journal of urology
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doi：10.1007/BF00182667
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abstract：:Nephrolithiasis is a highly prevalent disease worldwide with rates ranging from 7 to 13% in North America, 5-9% in Europe, and 1-5% in Asia. Due to high rates of new and recurrent stones, management of stones is expensive and the disease has a high level of acute and chronic morbidity. The goal of this study is to rev...
journal_title：World journal of urology
pub_type： 杂志文章,评审
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journal_title：World journal of urology
pub_type： 临床试验,杂志文章
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更新日期：1994-01-01 00:00:00
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journal_title：World journal of urology
pub_type： 杂志文章
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更新日期：2020-03-21 00:00:00
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journal_title：World journal of urology
pub_type： 杂志文章,评审
doi：10.1007/s00345-018-2374-8
更新日期：2019-03-01 00:00:00
