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Title: Trends in the surgical treatment of benign prostatic hyperplasia in a tertiary hospital.
Austin Authors: Ow, Darren;Papa, Nathan P;Perera, Marlon ;Liodakis, Peter ;Sengupta, Shomik ;Clarke, Stephen;Bolton, Damien M ;Lawrentschuk, Nathan
Affiliation: Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia
Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia
Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
Issue Date: Jan-2018 2017-03-19
Publication information: ANZ Journal of Surgery 2018; 88(1-2): 95-99
Abstract: To assess current treatment trends and perioperative outcomes of transurethral resection of the prostate (TURP) and photoselective vaporization of the prostate (PVP) in a tertiary institution. We prospectively collected a database of all patients undergoing TURP and PVP for benign prostatic hyperplasia (BPH) at a tertiary hospital between January 2011 and December 2013. Patient characteristics such as length of stay, readmission, anticoagulation status, American Society of Anesthesiologists (ASA) score and need for blood transfusion were recorded and analysed. In total, 560 cases were included: 204 (36.4%) underwent TURP and 356 (63.6%) PVP. Patients undergoing PVP had higher ASA scores (P < 0.001) and were more frequently on continuing anticoagulant therapy (P < 0.001). With regards to non-aspirin/asasantin coagulation therapy, 61 (17.1%) patients underwent PVP with their anticoagulants continued while no patients who received TURP continued anticoagulation. Blood transfusion percentages were similar at 1.0% for TURP and 1.7% for PVP but readmission proportions were higher after PVP (32 patients, 9.0%) compared to TURP (10 patients, 4.9%). These differences were attenuated when excluding patients continuing anticoagulation during the procedure. At our institution, the use of PVP has been increasing on a year-by-year basis. The results of the current study demonstrated that PVP is safe in patients with increased anaesthetic risk or on active anticoagulation when compared to traditional TURP. While this makes PVP an attractive alternative to TURP in high-risk anticoagulated patients, these patients may have complex post-discharge issues that should be addressed during the informed consent process.
DOI: 10.1111/ans.13904
ORCID: 0000-0003-3357-1216
PubMed URL: 28317227
Type: Journal Article
Subjects: anticoagulant
benign prostatic hyperplasia
laser therapy
risk factor
Appears in Collections:Journal articles

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