Comparison of Emergency Room Visits and Rehospitalization for Bleeding Complications following Transurethral Procedures for the Treatment of Benign Prostatic Hyperplasia: A Population-Based Retrospective Cohort Study
Background: The postoperative bleeding complications associated with laser surgery of the prostate and transurethral resection of the prostate (TURP) were compared. Methods: We used the Taiwan National Health Insurance Research Database to conduct an observational population-based cohort study. All...
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| Format: | Article |
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MDPI AG
2022-09-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/19/5662 |
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| author | Shih-Liang Chen Chih-Kai Hsu Chun-Hsiang Wang Che-Jui Yang Ting-Jui Chang Yu-Hsuan Chuang Yuan-Tsung Tseng |
| author_facet | Shih-Liang Chen Chih-Kai Hsu Chun-Hsiang Wang Che-Jui Yang Ting-Jui Chang Yu-Hsuan Chuang Yuan-Tsung Tseng |
| author_sort | Shih-Liang Chen |
| collection | DOAJ |
| description | Background: The postoperative bleeding complications associated with laser surgery of the prostate and transurethral resection of the prostate (TURP) were compared. Methods: We used the Taiwan National Health Insurance Research Database to conduct an observational population-based cohort study. All eligible patients who received transurethral procedures between January 2015 and September 2018 were enrolled. Patients who received laser surgery or TURP were matched at a ratio of 1:1 by using propensity score matching, and the association of these procedures with bleeding events was evaluated. Results: A total of 3302 patients who underwent elective transurethral procedures were included. The multivariable Cox regression analysis revealed that diode laser enucleation of the prostate (DiLEP) resulted in significantly higher emergency room risks within 90 days after surgery due to clot retention than the Monopolar transurethral resection of the prostate (M-TURP) (Hazard Ratio: 1.52; 95% Confidence Interval [CI], 1.06–2.16, <i>p</i> = 0.022). Moreover, GreenLight photovaporization of the prostate (PVP) (0.61; 95% CI, 0.38–1.00 <i>p</i> = 0.050) and thulium laser vaporesection of the prostate (ThuVARP) (0.67; 95% CI, 0.47–0.95, <i>p</i> = 0.024) resulted in significantly fewer rehospitalization due to clot retention than did M-TURP. No significant increase in blood clots were observed in patients using comedications and those with different demographic characteristics and comorbidities. Conclusions: Among the investigated six transurethral procedures for Benign prostatic hyperplasia, PVP and ThuVARP were safer than M-TURP because bleeding events and clot retention were less likely to occur, even in patients receiving anticoagulant or antiplatelet therapy. However, DiLEP and holmium laser enucleation of the prostate (HoLEP) did not result in fewer bleeding events than M-TURP. |
| first_indexed | 2024-03-09T21:34:47Z |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T21:34:47Z |
| publishDate | 2022-09-01 |
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| spelling | doaj.art-e3f1cca15c98434a906f6b2f62dc540a2023-11-23T20:46:44ZengMDPI AGJournal of Clinical Medicine2077-03832022-09-011119566210.3390/jcm11195662Comparison of Emergency Room Visits and Rehospitalization for Bleeding Complications following Transurethral Procedures for the Treatment of Benign Prostatic Hyperplasia: A Population-Based Retrospective Cohort StudyShih-Liang Chen0Chih-Kai Hsu1Chun-Hsiang Wang2Che-Jui Yang3Ting-Jui Chang4Yu-Hsuan Chuang5Yuan-Tsung Tseng6Department of Urology, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan City 701, TaiwanDepartment of Urology, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan City 701, TaiwanDepartment of Hepatogastroenterology, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan City 701, TaiwanDepartment of Urology, Chang Bing Show Chwan Memorial Hospital, Changhua 505, TaiwanDepartment of Urology, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan City 701, TaiwanDepartment of Urology, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan City 701, TaiwanDepartment of Medical Research, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan City 701, TaiwanBackground: The postoperative bleeding complications associated with laser surgery of the prostate and transurethral resection of the prostate (TURP) were compared. Methods: We used the Taiwan National Health Insurance Research Database to conduct an observational population-based cohort study. All eligible patients who received transurethral procedures between January 2015 and September 2018 were enrolled. Patients who received laser surgery or TURP were matched at a ratio of 1:1 by using propensity score matching, and the association of these procedures with bleeding events was evaluated. Results: A total of 3302 patients who underwent elective transurethral procedures were included. The multivariable Cox regression analysis revealed that diode laser enucleation of the prostate (DiLEP) resulted in significantly higher emergency room risks within 90 days after surgery due to clot retention than the Monopolar transurethral resection of the prostate (M-TURP) (Hazard Ratio: 1.52; 95% Confidence Interval [CI], 1.06–2.16, <i>p</i> = 0.022). Moreover, GreenLight photovaporization of the prostate (PVP) (0.61; 95% CI, 0.38–1.00 <i>p</i> = 0.050) and thulium laser vaporesection of the prostate (ThuVARP) (0.67; 95% CI, 0.47–0.95, <i>p</i> = 0.024) resulted in significantly fewer rehospitalization due to clot retention than did M-TURP. No significant increase in blood clots were observed in patients using comedications and those with different demographic characteristics and comorbidities. Conclusions: Among the investigated six transurethral procedures for Benign prostatic hyperplasia, PVP and ThuVARP were safer than M-TURP because bleeding events and clot retention were less likely to occur, even in patients receiving anticoagulant or antiplatelet therapy. However, DiLEP and holmium laser enucleation of the prostate (HoLEP) did not result in fewer bleeding events than M-TURP.https://www.mdpi.com/2077-0383/11/19/5662benign prostatic obstructiontransurethral resection of the prostatelaser surgery of the prostateclot retention |
| spellingShingle | Shih-Liang Chen Chih-Kai Hsu Chun-Hsiang Wang Che-Jui Yang Ting-Jui Chang Yu-Hsuan Chuang Yuan-Tsung Tseng Comparison of Emergency Room Visits and Rehospitalization for Bleeding Complications following Transurethral Procedures for the Treatment of Benign Prostatic Hyperplasia: A Population-Based Retrospective Cohort Study Journal of Clinical Medicine benign prostatic obstruction transurethral resection of the prostate laser surgery of the prostate clot retention |
| title | Comparison of Emergency Room Visits and Rehospitalization for Bleeding Complications following Transurethral Procedures for the Treatment of Benign Prostatic Hyperplasia: A Population-Based Retrospective Cohort Study |
| title_full | Comparison of Emergency Room Visits and Rehospitalization for Bleeding Complications following Transurethral Procedures for the Treatment of Benign Prostatic Hyperplasia: A Population-Based Retrospective Cohort Study |
| title_fullStr | Comparison of Emergency Room Visits and Rehospitalization for Bleeding Complications following Transurethral Procedures for the Treatment of Benign Prostatic Hyperplasia: A Population-Based Retrospective Cohort Study |
| title_full_unstemmed | Comparison of Emergency Room Visits and Rehospitalization for Bleeding Complications following Transurethral Procedures for the Treatment of Benign Prostatic Hyperplasia: A Population-Based Retrospective Cohort Study |
| title_short | Comparison of Emergency Room Visits and Rehospitalization for Bleeding Complications following Transurethral Procedures for the Treatment of Benign Prostatic Hyperplasia: A Population-Based Retrospective Cohort Study |
| title_sort | comparison of emergency room visits and rehospitalization for bleeding complications following transurethral procedures for the treatment of benign prostatic hyperplasia a population based retrospective cohort study |
| topic | benign prostatic obstruction transurethral resection of the prostate laser surgery of the prostate clot retention |
| url | https://www.mdpi.com/2077-0383/11/19/5662 |
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