Post-Operative Acute Urinary Retention After Greenlight Laser. Analysis of Risk Factors from A Multicentric Database Predicting Factors of Post-Operative Acute Urinary Retention After Greenlight Laser
Urology Journal,
Vol. 18 No. 06 (2021),
18 January 2022
,
Page 693-698
https://doi.org/10.22037/uj.v18i06.6489
Abstract
Purpose: Greenlight laser is a mini-invasive technique used to treat Benign Prostatic Obstruction (BPO). Some of the advantages of GreenLight photoselective vaporization (PVP) are shorter catheterization time and hospital stay compared to TURP. Post-operative acute urinary retention (pAUR) leads to patients' discomfort, prolonged hospital stay and increased health care costs. We analyzed risk factors for urinary retention after GreenLight laser PVP.
Materials and Methods: In a multicenter experience, we retrospectively analyzed the onset of early and late
post-operative acute urinary retention in patients undergoing standard or anatomical PVP. The pre-, intra- and
post-operative characteristics were compared betweene patients who started to void and the patients who developed post-operative urinary retention.
Results: The study included 434 patients suitable for the study. Post-operative acute urinary retention occurred in 39 (9%). Patients with a lower prostate volume (P < .001), an adenoma volume lower than 40 mL (P < .001), and lower lasing time (P = .013) had a higher probability to develop pAUR at the univariate analysis. The multivariate logistic regression confirmed that lower lasing time (95% CI: 0.86-0.99, OR = 0.93, P = .046) and adenoma volume (95% CI: 0.89–0.98, OR = 0.94, P = .006) are correlated to pAUR. Furthermore IPSS ≥ 19 (95% CI: 1.19- 10.75, OR = 2.27, P = .023) and treatment with 5-ARI (95% CI: 1.05-15.03, OR = 3.98, P = .042) are risk factors
for pAUR.
Conclusion: In our series, post-operative acute urinary retention was related to low adenoma volume and lasing time, pre-operative IPSS ≥ 19 and 5-ARI intake. These data should be considered in deciding the best timing for urethral catheters removal.
- GreenLight Laser
- Post-operative urinary retention
- Benign Prostatic Obstruction
- Risk Factors
How to Cite
References
2- Mordasini L, Moschini M, Mattei A, Iselin C. GreenLight Laser for benign prostatic hyperplasia. Curr Opin Urol 2018; 28(3):322-328.
3- Barco-Castillo C, Plata M, Zuluaga L, et al. Functional outcomes and safety of GreenLight photovaporization of the prostate in the high-risk patient with lower urinary tract symptoms due to benign prostatic enlargement. Neurourol Urodyn 2020;39(1):303-309.
4- Cindolo L, De Nunzio C, Greco F, et al. Standard vs. anatomical 180-W GreenLight laser photoselective vaporization of the prostate: a propensity score analysis. World J Urol 2018; 36(1):91-97.
5- Lai S, Peng P, Diao T, et al. Comparison of photoselective green light laser vaporisation versus traditional transurethral resection for benign prostate hyperplasia: an updated systematic review and meta-analysis of randomised controlled trials and prospective studies. BMJ Open 2019;9(8):e028855.
6- Cherrie RJ, Young RA, Cattolica EV. The safety of overnight hospitalization for transurethral prostatectomy: a prospective study of 200 patients. J Urol 1997;157:531-3.
7- Cornu JN, Herrmann T, Traxer O, Matlaga B. Prevention and Management Following Complications from Endourology Procedures. Eur Urol Focus 2016;2(1):49-59.
8- Chapple CR, Osman NI, Birder L, et al. The underactive bladder: a new clinical concept? Eur Urol 2015;68:351–3.
9- Bae WJ, Ahn SG, Bang JH, et al. Risk Factors for Failure of Early Catheter Removal After Greenlight HPS Laser Photoselective Vaporization Prostatectomy in Men With Benign Prostatic Hyperplasia. Korean J Urol 2013;54(1):31-5.
10- Kim SH, Yoo C, Choo M, Paick JS, Oh SJ. Factors affecting de novo urinary retention after Holmium laser enucleation of the prostate. PLoS One 2014 21;9(1):e84938.
11- Brassetti A, De Nunzio C, Delongchamps NB, Fiori C, Porpiglia F, Tubaro A. Green light vaporization of the prostate: is it an adult technique? Minerva Urol Nefrol 2017; 69(2):109-118.
12- Sosnowski R, De Nunzio C, Ahyai S, et al. Surgical management of benign prostatic obstruction: current practice patterns and attitudes in Europe. Neurourol Urodyn 2015; 34(4):395-6.
13- Li S, Zeng XT, Ruan XL, et al. Holmium laser enucleation versus transurethral resection in patients with benign prostate hyperplasia: an updated systematic review with meta-analysis and trial sequential analysis. PLoS One 2014 8;9(7):e101615.
14- Elmansy HM, Kotb A, Elhilali MM. Holmium laser enucleation of the prostate: long-term durability of clinical outcomes and complication rates during 10 years of follow up. J Urol 2011;186(5):1972-6.
15 - Campobasso D, Marchioni M, Altieri V, et al. GreenLight Photoselective Vaporization of the Prostate: One Laser for Different Prostate Sizes. J Endourol 2019 34(1):54-62
16- Cornu JN, Ahyai S, Bachmann A, et al. A Systematic Review and Meta-analysis of Functional Outcomes and Complications Following Transurethral Procedures for Lower Urinary Tract Symptoms Resulting from Benign Prostatic Obstruction: An Update. Eur Urol 2015;67(6):1066-1096.
17- Creta M, Colla' Ruvolo C, Longo N, et al. Detrusor overactivity and underactivity: implication for lower urinary tract symptoms related to benign prostate hyperplasia diagnosis and treatment. Minerva Urol Nefrol. 2020 Jan 30. doi: 10.23736/S0393-2249.20.03678-4
18- Thomas JA, Tubaro A, Barber N, et al. A Multicenter Randomized Noninferiority Trial Comparing GreenLight-XPS Laser Vaporization of the Prostate and Transurethral Resection of the Prostate for the Treatment of Benign Prostatic Obstruction: Two-yr Outcomes of the GOLIATH Study. Eur Urol 2016;69(1):94-102.
19- Castellan P, Castellucci R, Schips L, Cindolo L. Safety, efficacy and reliability of 180-W GreenLight laser technology for prostate vaporization: review of the literature. World J Urol 2015; 33(5):599-607.
20- Campbell NA, Chung ASJ, Yoon PD et al. Early experience photoselective vaporisation of the prostate using the 180 W lithium triborate and comparison with the 120 W lithium triborate
laser. Prostate Int 2013; 1:42–45.
21- Bachmann A, Muir GH, Collins EJ et al. 180-W XPS GreenLight laser therapy for benign prostate hyperplasia: early safety, efficacy, and perioperative outcome after 201 procedures. Eur Urol 2012; 61:600–607.
22- De Nunzio C, Presicce F, Tubaro A. Combination therapies for improved management of lower urinary tract symptoms/benign prostatic hyperplasia. Drugs Today (Barc) 2016; 52(9):501-517.
23- Fusco F, Creta M, De Nunzio C, Gacci M, Li Marzi V, Finazzi Agrò E. Alpha-1 adrenergic antagonists, 5-alpha reductase inhibitors, phosphodiesterase type 5 inhibitors, and phytotherapic compounds in men with lower urinary tract symptoms suggestive of benign prostatic obstruction: A systematic review and meta-analysis of urodynamic studies. Neurourol Urodyn 2018;37(6):1865-1874.
24- De Nunzio C, Brassetti A, Proietti F, et al. Dutasteride add-on therapy reduces detrusor mass in patients with benign prostatic enlargement not satisfied with alpha-adrenergic antagonist monotherapy: A single center prospective study. Neurourol Urodyn 2017;36(8):2096-2100.
25- Bosch R, Abrams P, Averbeck MA, et al. Do functional changes occur in the bladder due to bladder outlet obstruction? - ICI-RS 2018. Neurourol Urodyn 2019;38 Suppl 5:S56-S65.
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