The Predictive Factor for Favorable Outcome after Surgical Treatment of Benign Prostate Hyperplasia Performed by Young Urologist: Is Surgical Modality Important in Beginner Urologists?

Ki Hong Kim,Youn Soo Jeon,Hee Jo Yang

doi:10.15746/sms.21.014

Abstract

Objective: To identify predictive factors for favorable outcomes after surgical treatments that were performed by beginner urologists in patients with benign prostate hyperplasia (BPH), we retrospectively evaluated outcomes after holmium laser enucleation of the prostate (HoLEP) and transurethral resection of prostate (TURP) that were performed by two young urologists.Methods: Of 80 patients who were treated with HoLEP or TURP, 31 (HoLEP) and 36 (TURP) patients who were followed up for 3 months were enrolled in this study. Preoperative and perioperative variables were evaluated to identify predictive factors for favorable outcome after surgical treatment for BPH.Results: At 3 months postoperative after HoLEP or TURP, the median decrease in International Prostate Symptom Score (IPSS) was 13.0. Patients whose IPSS decreased by over 13 points were categorized into a favorable response group after HoLEP or TURP. Univariate and multivariate logistic regression analyses were performed to identify predictors of favorable outcomes at 3 months after HoLEP or TURP, and the preoperative IPSS was identified as an independent predictor for favorable outcomes.Conclusion: When young urologists plan to perform surgical treatment for BPH, they should consider that the severity of symptoms is the most important factor for favorable outcomes. The type of surgical modality for managing BPH is less important.

Highlights

Transurethral resection of prostate (TURP) has been the gold standard for surgical treatment of lower urinary tract symptoms due to benign prostate hyperplasia (BPH) [1]
Since holmium laser enucleation of the prostate (HoLEP) was introduced as the treatment for benign prostatic hyperplasia (BPH) [2], several clinicians have suggested that HoLEP could replace TURP as the current gold standard for the treatment of BPH [3]
Most young beginner urologists agonize over selecting HoLEP as a surgical modality for BPH, because most previous reports on the learning curve associated with HoLEP included only expert surgeons

Summary

Introduction

Transurethral resection of prostate (TURP) has been the gold standard for surgical treatment of lower urinary tract symptoms due to benign prostate hyperplasia (BPH) [1]. Most young beginner urologists agonize over selecting HoLEP as a surgical modality for BPH, because most previous reports on the learning curve associated with HoLEP included only expert surgeons. To the best of our knowledge, there is no comparative study in younger urologists regarding their learning curve for TURP and HoLEP. For this reason, the factors that should be considered for proper patient selection and surgical modality should be determined for young beginner urologists who decide to perform surgical treatment for BPH

Methods

Results

Conclusion