Giulioni Carlo, Tallè Matteo, Papaveri Alessio, Mengoni Francesco, Orciani Roberto, Pandolfo Savio Domenico, Imbimbo Ciro, Crocetto Felice, Maurizi Valentina, Gauhar Vineet, Cafarelli Angelo
Department of Urology, Casa di Cura Villa Igea, 60127 Ancona, Italy.
Department of Urology, University of L'Aquila, 67100 L'Aquila, Italy.
J Clin Med. 2025 May 13;14(10):3410. doi: 10.3390/jcm14103410.
: The aim of this study was to assess the efficacy and safety of Holmium Laser Enucleation of the Prostate (HoLEP) in the treatment of symptomatic benign prostatic hyperplasia (BPH) in elderly patients using the Trifecta Score, based on a 1-year follow-up. : We conducted a retrospective analysis of patients with BPH who underwent HoLEP at our institution between January 2016 and December 2022. The patients were divided into two groups: Group 1: patients aged ≥75 years, Group 2: patients aged below 74 years. The Trifecta Score achievement rates were then evaluated. Logistic regression analyses were performed to examine the impact of age on Trifecta parameters and to assess factors associated with urinary incontinence. : Overall, 981 participants were enrolled, with 490 in Group 1 and 491 in Group 2. Operative characteristics were similar between groups, though Group 1 had a longer time to catheter removal. At the 3-month follow-up, Group 1 had a higher IPSS and lower Qmax compared to Group 2, while there were no significant differences in functional outcomes by one year. In terms of postoperative morbidities, Group 1 exhibited a higher rate of blood transfusion. The Trifecta Score was similar between Groups 1 and 2 (63.5% vs. 68.8%, respectively, = 0.08), and no parameter of that score exhibited a negative correlation with age. : HoLEP demonstrates comparable functional outcomes to those observed in younger cohorts after one year. Overall, the Trifecta Score appears to be a valuable tool for this assessment. Nevertheless, incorporating an assessment of postoperative urinary continence and 1-year postoperative Qmax could enhance the system's validity.
本研究的目的是基于1年的随访，使用三元评分法评估钬激光前列腺剜除术（HoLEP）治疗老年有症状良性前列腺增生（BPH）患者的疗效和安全性。
我们对2016年1月至2022年12月在本机构接受HoLEP治疗的BPH患者进行了回顾性分析。患者分为两组：第1组：年龄≥75岁的患者，第2组：年龄低于74岁的患者。然后评估三元评分法的达成率。进行逻辑回归分析以检查年龄对三元评分参数的影响，并评估与尿失禁相关的因素。
总体而言，共纳入981名参与者，第1组490名，第2组491名。两组的手术特征相似，尽管第1组拔除导尿管的时间更长。在3个月的随访中，与第2组相比，第1组的国际前列腺症状评分（IPSS）更高，最大尿流率（Qmax）更低，而1年后功能结局无显著差异。在术后并发症方面，第1组的输血率更高。第1组和第2组的三元评分相似（分别为63.5%和68.8%，P = 0.08），且该评分的任何参数与年龄均无负相关。
HoLEP术后1年的功能结局与年轻队列中观察到的相当。总体而言，三元评分法似乎是一种有价值的评估工具。然而，纳入术后尿失禁评估和术后1年的Qmax可提高该系统的有效性。
