Lichtenberg Tobias, Wiedemann Andreas, Heppner Hans-Jürgen
Ev. Krankenhaus Witten gGmbH, Klinik für Urologie, Witten.
Universitat Witten, Lehrstuhl für Geriatrie, Witten.
Aktuelle Urol. 2020 Feb;51(1):59-64. doi: 10.1055/a-1069-7103. Epub 2020 Feb 4.
Transurethral resection of the prostate (TUR-P) is considered the gold standard in the surgical treatment of symptomatic benign prostatic hyperplasia. Besides the conventional TUR-P, there are numerous technological modifications of the procedure. An increasing use of the 180 W Greenlight-XPS™ laser vaporisation of the prostate (GLL) has been observed recently.
TUR-P and GLL have already been studied for safety, efficacy and economy. The aim of the present study was to analyse patient-related postsurgical aspects such as patient comfort and pain.
A total of 250 consecutive patients (100 TUR-P and 150 GLL) were analysed by examining anonymised medical records. Information on resection weight (TUR-P), applied energy (GLL), prostate volume, antiplatelet/anticoagulant therapy, catheter size, length of catheterisation, length of bladder irrigation, length of hospital stay and postoperative pain score was gathered.
The prostate volume was comparable between the two procedures (p = 0.434). The proportion of patients with ongoing antiplatelet and anticoagulant therapy was significantly higher with GLL (p < 0.0001). The catheter size was comparable with no statistical difference (p = 0.102). Length of catheterisation and duration of bladder irrigation were significantly shorter with GLL (p = 0.016 and p = 0.01). While the length of hospital stay was not statistically different (p = 0.233), a tendency to shorter hospital stays was seen with GLL. A similar postoperative pain score was observed with a low pain level in general and the highest scores being recorded shortly after the procedure.
The results demonstrate that GLL - a procedure preferably used for patients with ongoing antiplatelet and anticoagulant therapy - provides a high experience of postoperative comfort and offers potential for savings in terms of nursing resources (duration and intensity of bladder irrigation).
