Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, 117597, Singapore.
Department of Urology, Ng Teng Fong General Hospital, Jurong East, Singapore.
World J Urol. 2024 Aug 7;42(1):470. doi: 10.1007/s00345-024-05194-9.
We aimed to determine if preoperative prostate volume-enucleated weight concordance predicts short-term anatomical endoscopic enucleation of the prostate (AEEP) outcomes using the REAP international database.
649 patients with data on both preoperative ultrasound-derived prostate volume and enucleated specimen weight were analyzed. Linear regression was used to investigate the effect of volume-weight concordance on postoperative outcomes. Model residuals were used to divide the cohort into 3 centiles: (1) less-than-expected enucleated specimen weight; (2) appropriate concordance between prostate volume and specimen weight; (3) more-than-expected specimen weight. Outcomes were also analyzed with only enucleated weight as a predictor (comparing ≤ 80 g and > 80 g).
There was a trend towards more-than-expected enucleated specimen weight with increased age (p = 0.006). There was an increasing trend of operation time (p = 0.012) and enucleation time (p = 0.015) as specimen weight increased, and a decreasing trend of postoperative acute urinary retention (p = 0.005). Laser type, enucleation method, and early apical release were similar. In correlation analysis, greater-than-expected prostate weight was associated with greater Qmax improvement at 3 months. Prostate weight alone did not appear to be a significant predictor of outcomes.
If enucleated specimen weight is more than expected according to preoperative ultrasound volume measurement, greater Qmax improvement and less postoperative acute urinary retention is expected. Although precision may be limited by ultrasound approximation and inexact specimen weight measurements, these shortcomings are similar in real-world clinical practice. Overall, preoperative prostate volume and actual enucleated specimen weight should be interpreted in the context of each other to predict clinical outcomes.
我们旨在使用 REAP 国际数据库确定术前前列腺体积-切除标本重量一致性是否可以预测短期经内镜前列腺切除术（AEEP）的结果。
分析了 649 例同时具有术前超声前列腺体积和切除标本重量数据的患者。使用线性回归来研究体积-重量一致性对术后结果的影响。使用模型残差将队列分为 3 个百分位：（1）切除标本重量小于预期；（2）前列腺体积和标本重量之间存在适当的一致性；（3）切除标本重量大于预期。仅以切除标本重量为预测因子也分析了结果（比较≤80g 和>80g）。
随着年龄的增长，切除标本重量大于预期的趋势明显（p=0.006）。随着标本重量的增加，手术时间（p=0.012）和切除时间（p=0.015）呈上升趋势，而术后急性尿潴留（p=0.005）呈下降趋势。激光类型、切除方法和早期顶端释放相似。在相关分析中，与预期相比，前列腺重量较大与术后 3 个月时 Qmax 改善更大相关。单独的前列腺重量似乎不是结果的显著预测因子。
如果根据术前超声体积测量，切除标本重量超过预期，则预计 Qmax 改善更大，术后急性尿潴留更少。尽管超声估计和切除标本重量测量不精确可能会限制精度，但这些缺点在实际临床实践中是相似的。总体而言，术前前列腺体积和实际切除的标本重量应相互解释，以预测临床结果。
