Surgical reintervention requirements following GreenLight PVP: A single-center experience using three different laser device models


ÖZVEREN B., KARŞIYAKALI N., TURKERI L.

ARAB JOURNAL OF UROLOGY, cilt.22, sa.1, ss.31-38, 2024 (ESCI) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 22 Sayı: 1
  • Basım Tarihi: 2024
  • Doi Numarası: 10.1080/2090598x.2023.2222262
  • Dergi Adı: ARAB JOURNAL OF UROLOGY
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, EMBASE, Directory of Open Access Journals
  • Sayfa Sayıları: ss.31-38
  • Anahtar Kelimeler: Benign prostate hyperplasia, Bladder neck contracture, Greenlight, Photovaporization, Urethral stricture
  • Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Evet

Özet

ObjectiveTo assess the incidence, risk factors, and timing of specific causes of reoperations following PVP.Material and MethodsA retrospective analysis of data on men who underwent GreenLight PVP between 2004 and 2019 in a single center and required surgical intervention for bladder neck contracture (BNC), urethral stricture (US), or persistent/recurrent prostate adenoma.ResultsThe overall rate of reoperations was 13.8% during a 61-month median follow-up of 377 patients. Reoperations were due to BNC, US, and adenoma in 7.7%, 5.6%, and 4.8% of cases, respectively. The median interval until reoperation for US (11 months) was significantly shorter. None of the risk factors had any relevance to US. In patients who underwent reoperation for BNC, lasing time and energy were significantly lower, and the prostate volume was smaller; however, the multivariate analysis only identified shorter lasing time as a predictor. In patients who had reoperation for persistent/recurrent adenoma, the PSA was increased, while the prostate volume was non-significantly high, and performance by less-experienced surgeons was associated with a higher rate of reoperations (p < 0.05). A longer lasing time predicted an increased risk of reoperation for adenoma in multivariate analysis.ConclusionsAn unselective utilization of PVP may result in a relatively high rate of reoperations. The correlation of BNC with shorter lasing time may imply a higher risk after PVP of smaller prostates. A longer lasing time predicts an increased risk of reoperation due to persistent/recurrent adenoma, which may be related to higher prostate volumes and inefficient PVP by less-experienced surgeons.