"Finding the needle in a haystack": oncologic evaluation of patients treated for LUTS with holmium laser enucleation of the prostate (HoLEP) versus transurethral resection of the prostate (TURP).

World Journal of Urology
Annika HerlemannGiuseppe Magistro

Abstract

To evaluate oncologic parameters of men with bothersome LUTS undergoing surgical treatment with HoLEP or TURP. Five hundred and eighteen patients undergoing HoLEP (n = 289) or TURP (n = 229) were retrospectively analyzed for total PSA, prostate volume, PSA density, history of prostate biopsy, resected prostate weight, and histopathological features. Univariate and multivariate logistic regression models were used to identify independent predictors of incidental PCa (iPCa). Men undergoing HoLEP had a significantly higher total PSA (median 5.5 vs. 2.3 ng/mL) and prostate volume (median 80 vs. 41 cc), and displayed a greater reduction of prostate volume after surgery compared to TURP patients (median 71 vs. 50%; all p < 0.001). With a prevalence of incidental PCa (iPCa) of 15 and 17% for HoLEP and TURP, respectively, the choice of procedure had no influence on the detection of iPCa (p = 0.593). However, a higher rate of false-negative preoperative prostate biopsies was noted among iPCa patients in the HoLEP arm (40 vs. 8%, p = 0.007). In multivariate logistic regression, we identified patient age (OR 1.04; 95% CI 1.01-1.07, p = 0.013) and PSA density (OR 2.13; 95% CI 1.09-4.18, p = 0.028) as independent predictors for the detectio...Continue Reading

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Citations

Sep 10, 2020·World Journal of Urology·Gautier MüllhauptDominik Abt
Jun 3, 2018·World Journal of Urology·Bernd RosenhammerChristian Eichelberg
Jun 6, 2019·Minerva urologica e nefrologica = The Italian journal of urology and nephrology·Marco GiampaoliAngelo Porreca
Jul 15, 2021·AJR. American Journal of Roentgenology·Teresa A DiazMotoyo Yano
Nov 14, 2020·World Journal of Urology·Sercan YılmazLutfi Tunc

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