Ezaki Taisuke, Hongo Hiroshi, Takamatsu Kimiharu, Tanaka Nobuyuki, Oya Mototsugu
Department of Urology, Nerima General Hospital, Tokyo, Japan.
Department of Urology, Keio University School of Medicine, Tokyo, Japan.
Res Rep Urol. 2024 Jun 4;16:123-129. doi: 10.2147/RRU.S457307. eCollection 2024.
Contact laser vaporization of the prostate (CVP) for benign prostatic hyperplasia is a widely accepted and safe procedure for elderly patients because of its lower bleeding risks. However, CVP lacks a postoperative pathological examination for prostate cancer. Concomitant prostate biopsy and CVP may complement this disadvantage; however, the risk of bleeding associated with this procedure remains unclear. This study aimed to evaluate the safety of a concomitant prostate biopsy and CVP.
This retrospective study included 106 men who had undergone CVP in Nerima General Hospital. Prostate biopsies and CVP were performed simultaneously on 16 patients. We defined the "hemorrhage group" by a >5% decrease in hemoglobin the day after surgery. Preoperative and operative indices were evaluated based on the association with the hemorrhage group.
Participants in the concomitant biopsy group were older ( = 0.001), had larger prostates ( = 0.014), a lower rate of prostate biopsy history ( = 0.046), longer postoperative urinary catheter duration ( = 0.024), and a higher rate of decline in hemoglobin levels the day after surgery ( = 0.023). Patients in the hemorrhage group ( = 20, 18.9%) showed a significantly higher rate of concomitant biopsy and CVP ( = 0.006). Multivariate analysis showed that concomitant prostate biopsy ( = 0.009, odds ratio = 4.61) was the sole statistically significant predictive factor for hemorrhage.
Concomitant prostate biopsy and CVP of the prostate may increase the risk of bleeding.
对于良性前列腺增生患者,前列腺接触式激光汽化术(CVP)因其较低的出血风险,是老年患者广泛接受且安全的手术。然而,CVP缺乏对前列腺癌的术后病理检查。同期进行前列腺活检和CVP可能弥补这一不足;然而,该手术相关的出血风险仍不明确。本研究旨在评估同期进行前列腺活检和CVP的安全性。
这项回顾性研究纳入了106例在练马综合医院接受CVP的男性患者。16例患者同时进行了前列腺活检和CVP。我们将术后第一天血红蛋白下降>5%定义为“出血组”。基于与出血组的关联评估术前和手术指标。
同期活检组的参与者年龄更大(P = 0.001),前列腺更大(P = 0.014),有前列腺活检史的比例更低(P = 0.046),术后留置导尿管时间更长(P = 0.024),术后第一天血红蛋白水平下降率更高(P = 0.023)。出血组患者(n = 20,18.9%)同期进行活检和CVP的比例显著更高(P = 0.006)。多因素分析显示,同期进行前列腺活检(P = 0.009,比值比 = 4.61)是出血唯一具有统计学意义的预测因素。
同期进行前列腺活检和CVP可能增加出血风险。