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.
World journal of urology. 2024 Aug 07*** epublish ***
Khi Yung Fong, Vineet Gauhar, Daniele Castellani, Ee Jean Lim, Mario Sofer, Dmitry Enikeev, Fernando Gómez Sancha, Jeremy Teoh, Bhaskar Somani, Thomas Herrmann
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., Urology Unit, Azienda Ospedaliero-Universitaria delle Marche, Università Politecnica delle Marche, Ancona, Italy., Department of Urology, Singapore General Hospital, Outram Road, Singapore., Department of Urology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel., Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russian Federation., Department of Urology and Robotic Surgery, ICUA-Clínica CEMTRO, Madrid, Spain., S.H. Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China., Department of Urology, University Hospitals Southampton, NHS Trust, Southampton, UK., Department of Urology, Kantonspital Frauenfeld, Spital Thurgau AG, Frauenfeld, Switzerland.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/39110254