Holmium laser enucleation of prostate in nonagenarians and octogenarians Impact of age and frailty on surgical outcomes.
| Autor: | Elsaqa M; Baylor Scott & White Health, CTX, Temple, TX, United States.; Alexandria University Faculty of Medicine, Alexandria, Egypt., Zhang Y; Baylor Scott & White Health, CTX, Temple, TX, United States., El Tayeb MM; Baylor Scott & White Health, CTX, Temple, TX, United States. |
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| Jazyk: | angličtina |
| Zdroj: | Canadian Urological Association journal = Journal de l'Association des urologues du Canada [Can Urol Assoc J] 2023 Sep; Vol. 17 (9), pp. E263-E268. |
| DOI: | 10.5489/cuaj.8211 |
| Abstrakt: | Introduction: Holmium laser enucleation of the prostate (HoLEP) is a well-established technique for management of benign prostatic hyperplasia (BPH). With the growing aging population, a considerable percentage of octogenarians (80-90 years old) and nonagenarians (>90 years old) require surgical management for BPH. We aimed to assess the outcomes of HoLEP in those age groups. Methods: We reviewed a maintained database for HoLEP patients in a tertiary center. Patients were assigned to two groups: above (group A) and below (group B) 80 years old. Perioperative outcome and postoperative followup data were compared between both groups. Results: The study included 1090 patients, 201 and 889 in groups A and B, respectively. Median age was 83 and 70 years in groups A and B, respectively. Group A showed longer operative time, longer catheterization time, and higher 30-day emergency room visits and readmission rates. Hemoglobin drop was comparable, although associated with higher rate of blood transfusion in group A. Overall, 30-day postoperative complications were higher in group A (20.8% vs. 9.3%, p=0.008), although the majority of complications in both groups were grade I and II. The rate of complications over Clavien-Dindo grade II were statistically comparable (3.4% vs. 1.79%, p=0.133). Followup at six weeks, three months, and one year showed comparable functional outcomes in both groups. Conclusions: HoLEP is a safe and effective option in the geriatric population of octogenarians and even nonagenarians. HoLEP is associated with higher overall complication rate in older age groups; however, most complications were minor. |
| Databáze: | MEDLINE |
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