A randomized controlled trial comparing high and medium power settings for holmium laser enucleation of prostate.

Autor: Shah HN; Department of Urology, Miller School of Medicine, University of Miami, Miami, USA. drhemendrashah@yahoo.co.in., Etafy MH; Department of Urology, Miller School of Medicine, University of Miami, Miami, USA., Katz JE; Department of Urology, Miller School of Medicine, University of Miami, Miami, USA., Garcia Lopez EA; Miller School of Medicine, University of Miami, Miami, USA., Shah RH; Urolap Superspeciality Clinic and S. L. Raheja (Fortis Associate Hospital), Mumbai, India.
Jazyk: angličtina
Zdroj: World journal of urology [World J Urol] 2021 Aug; Vol. 39 (8), pp. 3005-3011. Date of Electronic Publication: 2021 Jan 04.
DOI: 10.1007/s00345-020-03535-y
Abstrakt: Purpose: To report the results of a randomized controlled trial comparing outcomes between medium power (MP) and high power (HP) laser settings for HoLEPs.
Methods: The primary objective was to compare the enucleation efficiency (EE) of HP- HoLEP (80-100 W) with MP-HoLEP (50 - 60 W). The secondary objectives were to compare treatment efficacy and safety between both groups. To show a 25% difference in EE, a sample size of 45 individuals per treatment arm was required (alpha = 0.05; Beta = 0.80). Patients demographic and perioperative factors were analyzed, including EE, hemoglobin drop, duration of catheterization, and length of hospital stay. The surgical outcome was evaluated with AUA symptom score, maximum flow rate, postvoid residual urine, and complications to assess differences between MP and HP HoLEP at baseline, 3 months, 1, and 5 years. Quantitative outcomes were compared with independent sample t tests (2-tailed) and qualitative outcomes were compared with chi-square tests.
Results: Preoperative data with the exception of indication for surgery were comparable in both treatment arms. There was no statistically significant difference in enucleation efficiency between the HP-HoLEP and MP-HoLEP laser setting (0.97 ± 0.47 vs. 0.85 ± 0.47 gm/min, p = 0.209). MP laser settings did not increase perioperative or postoperative complications and resulted in durable outcome comparable with HP laser settings at 5-year follow-up.
Conclusions: MP-HoLEP is safe and efficient and does not compromise the outcome for HoLEPs when compared with HP-HoLEP.
(© 2021. Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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