Lv Kaikai, Wu Yangyang, Huang Shuai, Luo Zhenjun, Lai Wenhui, Meng Qingyang, Xia Xinze, Lv Chao, Hao Xiaowei, Song Tao, Yuan Qing
Department of Urology, the Third Medical Centre, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
Medical School of Chinese People's Liberation Army (PLA), Beijing, China.
Front Surg. 2023 Jan 10;9:1063649. doi: 10.3389/fsurg.2022.1063649. eCollection 2022.
To investigate the association between age, metabolic syndrome (MetS) and improvement in nocturia in patients with benign prostate hyperplasia (BPH) receiving holmium laser enucleation of the prostate (HoLEP).
The retrospective study was conducted on patients treated for BPH using HoLEP between January 2021 and May 2022. Lower urinary tract symptoms (LUTS) were measured before surgery and at 3 months postoperatively using the International Prostate Symptom Score (IPSS). The criteria of the Adult Treatment Panel III (ATP III) were adopted to diagnose the MetS. Unsatisfactory improvement in nocturia was defined as <50% reduction in nocturia from baseline on the IPSS.
One hundred and seventy-five patients were eventually enrolled, with a median age of 69 years (IQR: 63/73). Unsatisfactory improvement in nocturia was reported in 95 patients (54%) after HoLEP. These patients were older (73; IQR: 67/79 vs. 66; IQR: 60/71, < 0.001) and more likely to present with higher postoperative total (6; IQR: 4/9 vs. 3; IQR:2/5, < 0.001), voiding (1; IQR: 0/3 vs. 1; IQR: 0/2, = 0.017), and storage (4; IQR: 3/6 vs. 2; IQR: 1/4, < 0.001) IPSS when compared to patients with satisfactory improvement in nocturia. Overall, 63 of 175 (36%) patients were diagnosed with MetS and of these, 44 (70%) reported unsatisfactory improvement in nocturia ( = 0.002) after HoLEP. Multivariate analysis revealed that age (OR = 1.117, 95% CI: 1.068-1.169, < 0.001) and MetS (OR = 3.613, 95% CI: 1.727-7.562, = 0.001) were independent risk factors for unsatisfactory improvement in nocturia after HoLEP.
Our findings suggest that increased age and MetS were associated with unsatisfactory improvement in nocturia in patients with BPH after HoLEP. Lifestyle management, including weight loss, may be of great importance in the improvement of nocturia.
探讨接受钬激光前列腺剜除术（HoLEP）的良性前列腺增生（BPH）患者的年龄、代谢综合征（MetS）与夜尿改善情况之间的关联。
对2021年1月至2022年5月期间接受HoLEP治疗的BPH患者进行回顾性研究。术前及术后3个月使用国际前列腺症状评分（IPSS）测量下尿路症状（LUTS）。采用成人治疗小组第三次报告（ATP III）的标准诊断MetS。夜尿改善不明显定义为IPSS中夜尿较基线减少<50%。
最终纳入175例患者，中位年龄为69岁（四分位间距：63/73）。HoLEP术后95例患者（54%）报告夜尿改善不明显。这些患者年龄较大（73岁；四分位间距：67/79，而改善明显的患者为66岁；四分位间距：60/71，<0.001），术后总IPSS（6分；四分位间距：4/9，而改善明显的患者为3分；四分位间距：2/5，<0.001）、排尿IPSS（1分；四分位间距：0/3，而改善明显的患者为1分；四分位间距：0/2，=0.017）及储尿IPSS（4分；四分位间距：3/6，而改善明显的患者为2分；四分位间距：1/4，<0.001）更高。总体而言，175例患者中有63例（36%）被诊断为MetS，其中44例（70%）报告HoLEP术后夜尿改善不明显（=0.002）。多因素分析显示，年龄（比值比[OR]=1.117，95%置信区间[CI]：1.068 - 1.169，<0.001）和MetS（OR = 3.613，95% CI：1.727 - 7.
