The impact of 5-ARI on perioperative and functional outcomes of GreenLight PVP: an analysis of the Global GreenLight Group database.

Autor: Elsherbini T; Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada., Bouhadana D; Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada., Sadri I; Division of Urology, McGill University, Montreal, Quebec, Canada., Nguyen DD; Division of Urology, University of Toronto, Toronto, Ontario, Canada., Law KW; Division of Urology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada., Arezki A; Division of Urology, McGill University, Montreal, Quebec, Canada., Deyirmendjian C; Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada., Ibrahim A; Division of Urology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada., Bhojani N; Division of Urology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada., Elterman DS; Division of Urology, University Health Network, Toronto, Ontario, Canada., Chughtai B; Department of Urology, Weill Cornell Medical College, New York, New York, USA., Bruyère F; Department of Oncology and Urology, Centre Hospitalier Universitaire de Tours, Centre-Val de Loire, France., Cindolo L; Department of Urology, Hesperia Hospital, 'Cure Group', Modena, Italy., Ferrari G; Department of Urology, Hesperia Hospital, 'Cure Group', Modena, Italy., Vasquez-Lastra C; Department of Urology, ABC Medical Center, Mexico City, Mexico., Borelli-Bovo T; Borelli Urologia, Ribeirão Presto, Sao Paulo, Brazil., Becher EF; Centro de Urologia, CDU, Buenos Aires, Argentina., Cash H; Prouro, Urology Berlin, Berlin, Germany and Department of Urology, University of Magdeburg, Magdeburg, Germany., Reimann M; Department of Urology, Charite - Universitaetsmedizin Berlin, Berlin, Germany., Rijo E; Department of Urology, Hospital Quiron Barcelona, Barcelona, Spain., Misrai V; Department of Urology, Clinique Pasteur, Toulouse, France., Zorn KC; Division of Urology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada.
Jazyk: angličtina
Zdroj: The Canadian journal of urology [Can J Urol] 2023 Apr; Vol. 30 (2), pp. 11473-11479.
Abstrakt: Introduction: In this study, we sought to investigate the impact of 5-alpha reductase inhibitors (5-ARI) on the perioperative and functional outcomes of 180-Watt XPS GreenLight photovaporization of the prostate (PVP) using a large international database.
Materials and Methods: Data were obtained from the Global GreenLight Group (GGG) database, which includes eight high-volume, experienced surgeons from seven international centers.  All men with established benign prostatic hyperplasia (BPH) with known 5-ARI status who underwent GreenLight PVP using the XPS-180W system between 2011 and 2019 were eligible for the study.  Patients were assigned to two groups based on the preoperative use of 5-ARI.  Analyses were adjusted for patient age, prostate volume, and American Society of Anesthesia (ASA) score.
Results: We included 3,500 men, of which 1,246 (36%) had preoperative 5-ARI use.  Patients in both groups were similar with regards to age and prostate size.  On multivariable analysis, total operative time was slightly shorter (-3.26 min 95% CI: 1.20 - 5.32, p < 0.01) and required 35.6kJ less laser energy (95% CI: -48.0kJ - -23.3kJ, p < 0.01) for patients on 5ARI compared to those without 5-ARI.  However, no clinically significant difference was appreciated regarding postoperative transfusion rates [OR 0.048 (95% CI -0.82-0.91; p = 0.91)], hematuria rates [OR 0.96 (95% CI 0.72-1.3; p = 0.81)], 30-day readmission rates [OR 0.98 (95% CI 0.71-1.4; p = 0.90)], or overall functional outcomes.
Conclusion: Our findings suggest that preoperative 5-ARI is not associated with any clinically significant different perioperative or functional outcomes for GreenLight PVP using the XPS-180W system.  There is no role for the initiation or discontinuation of 5-ARI prior to GreenLight PVP.
Databáze: MEDLINE
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