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Super early detailed assessment of lower urinary tract symptoms after holmium laser enucleation of the prostate (HoLEP): a prospective study.
World Journal of Urology ( IF 2.8 ) Pub Date : 2020-02-21 , DOI: 10.1007/s00345-020-03126-x
Sascha A Ahyai 1 , Irina Marik 2 , Tim A Ludwig 2 , Andreas Becker 3 , Saman Asdjodi 1 , Luis Kluth 3 , Felix Chun 3 , Margit Fisch 2 , Marianne Schmid 1
Affiliation  

PURPOSE To prospectively investigate early and consecutive changes of lower urinary tract symptoms (LUTS), specifically storage symptoms after holmium laser enucleation of the prostate (HoLEP). METHODS Patients referred for HoLEP completed the International Prostatic Symptom Score (IPSS) the day before, at discharge, and 1, 2, 3, 4, 6, 8, 12, 16, 20, 24, and 52 weeks after HoLEP. Total IPSS was stratified into mild (score 0-7), moderate (8-19), and severe (20-35) LUTS. Storage symptoms were sub-stratified into storage "negative" and "positive". IPSS changes served as the main postoperative outcome. Mixed linear models identified risk factors affecting postoperative recovery of LUTS. RESULTS Between December 2010 and 2012, 144 consecutive HoLEP patients were prospectively included in the study. Preoperatively 57.6% of the cohort reported severe storage symptoms (mean total IPSS: 22.6 ± 5.0). Total IPSS decreased significantly immediately after surgery (p < 0.001). Patients with severe LUTS, storage-positive sub-score, and high maximum urinary flow rate were affected by a rebound of mainly storage symptoms 6-8 weeks after HoLEP and prolonged recovery from LUTS. Of these, about 7.4% presented persisting urge complaints. Finally, 12 weeks following HoLEP, the vast majority of patients were symptom-free. Limitations of this study include missing urodynamic workup and a comparative patient cohort. CONCLUSION Immediately after HoLEP, patients experience a significant decrease of LUTS. Continuous symptom recovery seems to be hampered in patients with severe and storage-positive baseline symptoms. (De-novo) storage symptoms slightly affect postoperative recovery. Quality of life is restored to a stable and significantly improved status 3 months after surgery.

中文翻译:

前列腺激光摘除术(HoLEP)后超早期详细评估下尿路症状:一项前瞻性研究。

目的前瞻性研究下尿路症状(LUTS)的早期和连续变化,特别是激光摘除前列腺(HoLEP)后的储尿症状。方法接受HoLEP治疗的患者在出院前一天,HoLEP治疗后1、2、3、4、6、8、12、16、20、24和52周完成国际前列腺症状评分(IPSS)。总IPSS分为轻度(得分0-7),中度(8-19)和重度(20-35)LUTS。储存症状分为“阴性”和“阳性”储存。IPSS改变是术后的主要结局。混合线性模型确定了影响LUTS术后恢复的危险因素。结果在2010年12月至2012年之间,前瞻性纳入了144位HoLEP患者。术前57。6%的队列人群报告了严重的存储症状(平均IPSS:22.6±5.0)。手术后即刻总IPSS显着下降(p <0.001)。重度LUTS,储存阳性亚评分和最大尿流率高的患者在HoLEP术后6-8周受到主要储存症状的反弹和从LUTS康复的影响。其中,约有7.4%的人提出了持续的敦促申诉。最后,HoLEP术后12周,绝大多数患者无症状。该研究的局限性包括缺少尿动力学检查和比较患者队列。结论HoLEP术后,患者的LUTS明显减少。具有严重和储存阳性基线症状的患者,持续的症状恢复似乎受到阻碍。(De-novo)储存症状轻微影响术后恢复。术后3个月,生活质量恢复到稳定并显着改善的状态。
更新日期:2020-02-21
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