Propensity score-matched analysis comparing perioperative, functional, and safety outcomes between thulium fiber laser and bipolar enucleation of the prostate performed by a single surgeon with two years of follow-up
Purpose: To compare perioperative, functional, and safety outcomes between thulium fiber laser enucleation of the prostate (ThuFLEP) and bipolar enucleation of the prostate performed by a single surgeon with use of propensity score (PS)-matched analysis. Materials and Methods: Data were from 675 pa...
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| Format: | Article |
| Language: | English |
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Korean Urological Association
2024-03-01
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| Series: | Investigative and Clinical Urology |
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| Online Access: | https://www.icurology.org/pdf/10.4111/icu.20230270 |
| _version_ | 1797271453262938112 |
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| author | Armais Albertovich Kamalov Nikolay Ivanovich Sorokin Vitaly Kazichanovich Dzitiev Andrey Alekseevich Strigunov Olga Yurevna Nesterova Ilya Vladimirovich Bondar |
| author_facet | Armais Albertovich Kamalov Nikolay Ivanovich Sorokin Vitaly Kazichanovich Dzitiev Andrey Alekseevich Strigunov Olga Yurevna Nesterova Ilya Vladimirovich Bondar |
| author_sort | Armais Albertovich Kamalov |
| collection | DOAJ |
| description | Purpose: To compare perioperative, functional, and safety outcomes between thulium fiber laser enucleation of the prostate (ThuFLEP) and bipolar enucleation of the prostate performed by a single surgeon with use of propensity score (PS)-matched analysis.
Materials and Methods: Data were from 675 patients, 422 of whom underwent ThuFLEP and bipolar enucleation by a single highly experienced surgeon. ThuFLEP was performed with Fiberlase U1 (IRE Polus Ltd.). Perioperative parameters, safety, and functional outcomes, such as International Prostate Symptom Score (IPSS), quality of life (QoL), postvoid residual volume (PVR), and maximum urinary flow rate (Qmax) were assessed. To control for selection bias, a 1:1 PS-matched analysis was carried out using the following variables as covariates: total prostate volume, preoperative IPSS and early sphincter release.
Results: Of 422 patients, 370 (87.7%) underwent ThuFLEP and 52 (12.3%) underwent bipolar enucleation. Operation, enucleation, and morcellation time were comparable between groups before and after PS-matched analysis (p=0.954, p=0.474, p=0.362, respectively). Functional parameters (IPSS, QoL, PVR, Qmax) were also comparable between groups at every time point before and after PS matching. Significant improvements in IPSS, QoL score, Qmax, and PVR were observed during the 24-month follow-up period for both ThuFLEP and bipolar enucleation without any significant differences between groups. Early and late postoperative complications before and after PS-matched analysis were similar.
Conclusions: ThuFLEP was comparable to bipolar enucleation in perioperative characteristics, improvement in voiding parameters, and complication rates. Both procedures were shown to be effective and safe in the management of benign prostatic hyperplasia. |
| first_indexed | 2024-03-07T14:02:57Z |
| format | Article |
| id | doaj.art-55d4c5b6e63e49dcb10ff977ebcc0b17 |
| institution | Directory Open Access Journal |
| issn | 2466-0493 2466-054X |
| language | English |
| last_indexed | 2024-03-07T14:02:57Z |
| publishDate | 2024-03-01 |
| publisher | Korean Urological Association |
| record_format | Article |
| series | Investigative and Clinical Urology |
| spelling | doaj.art-55d4c5b6e63e49dcb10ff977ebcc0b172024-03-07T04:34:24ZengKorean Urological AssociationInvestigative and Clinical Urology2466-04932466-054X2024-03-0165213914710.4111/icu.20230270Propensity score-matched analysis comparing perioperative, functional, and safety outcomes between thulium fiber laser and bipolar enucleation of the prostate performed by a single surgeon with two years of follow-upArmais Albertovich Kamalov0https://orcid.org/0000-0003-4251-7545Nikolay Ivanovich Sorokin1https://orcid.org/0000-0001-9466-7567Vitaly Kazichanovich Dzitiev2https://orcid.org/0000-0001-7558-589XAndrey Alekseevich Strigunov3https://orcid.org/0000-0003-4518-634XOlga Yurevna Nesterova4https://orcid.org/0000-0003-3355-4547Ilya Vladimirovich Bondar5https://orcid.org/0009-0004-7079-2434Department of Urology and Andrology, Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, Russian Federation.Department of Urology and Andrology, Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, Russian Federation.Department of Urology and Andrology, Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, Russian Federation.Department of Urology and Andrology, Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, Russian Federation.Department of Urology and Andrology, Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, Russian Federation.Department of Urology and Andrology, Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, Russian Federation.Purpose: To compare perioperative, functional, and safety outcomes between thulium fiber laser enucleation of the prostate (ThuFLEP) and bipolar enucleation of the prostate performed by a single surgeon with use of propensity score (PS)-matched analysis. Materials and Methods: Data were from 675 patients, 422 of whom underwent ThuFLEP and bipolar enucleation by a single highly experienced surgeon. ThuFLEP was performed with Fiberlase U1 (IRE Polus Ltd.). Perioperative parameters, safety, and functional outcomes, such as International Prostate Symptom Score (IPSS), quality of life (QoL), postvoid residual volume (PVR), and maximum urinary flow rate (Qmax) were assessed. To control for selection bias, a 1:1 PS-matched analysis was carried out using the following variables as covariates: total prostate volume, preoperative IPSS and early sphincter release. Results: Of 422 patients, 370 (87.7%) underwent ThuFLEP and 52 (12.3%) underwent bipolar enucleation. Operation, enucleation, and morcellation time were comparable between groups before and after PS-matched analysis (p=0.954, p=0.474, p=0.362, respectively). Functional parameters (IPSS, QoL, PVR, Qmax) were also comparable between groups at every time point before and after PS matching. Significant improvements in IPSS, QoL score, Qmax, and PVR were observed during the 24-month follow-up period for both ThuFLEP and bipolar enucleation without any significant differences between groups. Early and late postoperative complications before and after PS-matched analysis were similar. Conclusions: ThuFLEP was comparable to bipolar enucleation in perioperative characteristics, improvement in voiding parameters, and complication rates. Both procedures were shown to be effective and safe in the management of benign prostatic hyperplasia.https://www.icurology.org/pdf/10.4111/icu.20230270benign prostatic hyperplasiaminimally invasive surgical procedurepropensity scorethulium |
| spellingShingle | Armais Albertovich Kamalov Nikolay Ivanovich Sorokin Vitaly Kazichanovich Dzitiev Andrey Alekseevich Strigunov Olga Yurevna Nesterova Ilya Vladimirovich Bondar Propensity score-matched analysis comparing perioperative, functional, and safety outcomes between thulium fiber laser and bipolar enucleation of the prostate performed by a single surgeon with two years of follow-up Investigative and Clinical Urology benign prostatic hyperplasia minimally invasive surgical procedure propensity score thulium |
| title | Propensity score-matched analysis comparing perioperative, functional, and safety outcomes between thulium fiber laser and bipolar enucleation of the prostate performed by a single surgeon with two years of follow-up |
| title_full | Propensity score-matched analysis comparing perioperative, functional, and safety outcomes between thulium fiber laser and bipolar enucleation of the prostate performed by a single surgeon with two years of follow-up |
| title_fullStr | Propensity score-matched analysis comparing perioperative, functional, and safety outcomes between thulium fiber laser and bipolar enucleation of the prostate performed by a single surgeon with two years of follow-up |
| title_full_unstemmed | Propensity score-matched analysis comparing perioperative, functional, and safety outcomes between thulium fiber laser and bipolar enucleation of the prostate performed by a single surgeon with two years of follow-up |
| title_short | Propensity score-matched analysis comparing perioperative, functional, and safety outcomes between thulium fiber laser and bipolar enucleation of the prostate performed by a single surgeon with two years of follow-up |
| title_sort | propensity score matched analysis comparing perioperative functional and safety outcomes between thulium fiber laser and bipolar enucleation of the prostate performed by a single surgeon with two years of follow up |
| topic | benign prostatic hyperplasia minimally invasive surgical procedure propensity score thulium |
| url | https://www.icurology.org/pdf/10.4111/icu.20230270 |
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