Laser Vaporization of the Prostate With the 180-W XPS-Greenlight Laser in Patients With Ongoing Platelet Aggregation Inhibition and Oral Anticoagulation
| Autor: | Heike Pueschel, Steven A. Kaplan, Alexander Bachmann, Daniel J. Lee, Bilal Chughtai, Fujun Zhao, Malte Rieken, Richard K. Lee, Joshua A. Halpern, Alexis E. Te |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Urethral stricture Urology medicine.medical_treatment Prostatic Hyperplasia 030232 urology & nephrology Administration Oral 03 medical and health sciences Postoperative Complications 0302 clinical medicine Prostate medicine Humans Intraoperative Complications Aged Retrospective Studies Aged 80 and over Prostatectomy Aspirin business.industry Warfarin Anticoagulants Postoperative complication Middle Aged medicine.disease Surgery Treatment Outcome medicine.anatomical_structure 030220 oncology & carcinogenesis Platelet aggregation inhibitor International Prostate Symptom Score Laser Therapy business Platelet Aggregation Inhibitors medicine.drug |
| Zdroj: | Urology. 91:167-173 |
| ISSN: | 0090-4295 |
| DOI: | 10.1016/j.urology.2016.01.021 |
| Popis: | Objective To characterize the safety and efficacy of the 180-W XPS-Greenlight laser in patients on systemic anticoagulation. Materials and Methods A retrospective analysis of 384 patients who underwent photoselective vaporization of the prostate with the 180-W XPS-laser between 2010 and 2013 at two centers in the United States and Switzerland was performed. The primary outcome was the intraoperative and postoperative complication rates for those on anticoagulation undergoing photoselective vaporization of the prostate. The secondary outcome was International Prostate Symptom Scores, postvoid residual, maximum flow rate, and prostate-specific antigen levels. Results Of 384 patients, aspirin, clopidogrel, and warfarin were used in 146 (38%), 34 (8.9%), and 57 (14.8%) patients, respectively. Single-drug, two-drug, and three-drug combinations were used in 142 (35.5%), 37 (9.3%), and 7 (1.7%) of the cases. Median lasing time (39 min vs 36 min; P = .99) and number of fibers used (1.0 vs 1.0; P = .63) were comparable between patients on vs off systemic anticoagulation. Postoperatively, urinary symptoms (International Prostate Symptom Score, quality of life) and objective voiding parameters (maximum flow rate, postvoid residual) improved in both groups of patients. During a maximum follow-up of 2 years, patients on vs off systemic anticoagulation did not show any significant differences in the rate of postoperative urinary tract infection (3.8% vs 5.1%; P = .71), retention (5.1% vs 5.9%; P = .71), urethral stricture (1.5% vs none, P = .05), and reoperation (2.2% vs 1.5%; P = .49). The primary limitation is the retrospective nature of the study. Conclusion Photovaporization of the prostate with the 180-W XPS-laser is a safe and effective minimal-invasive treatment option for patients on systemic anticoagulation. |
| Databáze: | OpenAIRE |
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