Holmium Laser Enucleation of the Prostate and High-Intensity Focused Ultrasound for Prostate Cancer
Author Information
Author(s): Delgado Jessica, Porto Joao G., Bhatia Ansh, Raymo Adele, Blachman-Braun Ruben, Ajami Tarek, Rathinam Aravindh, Freitas Pedro F. S., Khandekar Archan, Marcovich Robert, Parekh Dipen J., Nahar Bruno, Shah Hemendra N.
Primary Institution: University of Miami Miller School of Medicine
Hypothesis
The study aimed to evaluate the functional outcomes of patients undergoing simultaneous holmium laser enucleation of the prostate (HoLEP) and high-intensity focused ultrasound (HIFU) compared to those who underwent HoLEP alone.
Conclusion
Patients undergoing HoLEP combined with HIFU have a higher risk of post-operative acute urinary retention and delayed recovery from transient urinary incontinence, but similar rates of other complications compared to HoLEP alone.
Supporting Evidence
- Patients undergoing HIFU+HoLEP experienced higher rates of acute urinary retention.
- Postoperative urinary tract infection rates were similar between the groups.
- Continence rates at the 6-week follow-up were similar, but the combined therapy group took longer to regain continence.
- Both groups showed equal improvements in International Prostate Symptom Scores at 6 and 12 months.
Takeaway
This study looked at how two treatments for prostate issues work together. It found that while one treatment can help, it might also cause some problems like needing to go to the bathroom suddenly.
Methodology
A retrospective review of patients who underwent HoLEP combined with HIFU or HoLEP alone, with propensity matching based on age and prostate volume.
Potential Biases
The study did not compare outcomes with staged procedures and had incomplete continence outcomes for some patients.
Limitations
The study was a retrospective analysis from a single institution with short follow-up data, limiting generalizability.
Participant Demographics
Patients included were those with localized prostate cancer and benign prostatic hyperplasia, with a mean age of approximately 73 years.
Statistical Information
P-Value
p=0.016
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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