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Vol. 37. Issue 1.
Pages 20-24 (January 2013)
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Vol. 37. Issue 1.
Pages 20-24 (January 2013)
Original article
DOI: 10.1016/j.acuroe.2012.03.014
Analysis of predictive factors of success for prostate photovaporization in benign prostatic hyperplasia by greenlight laser
Análisis de factores predictivos de éxito para la fotovaporización próstatica en hiperplasia benigna de próstata mediante láser verde
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J. Miralles, J.L. Palmero??
Corresponding author
joseluispalmer@hotmail.com

Corresponding author.
, M. Ramírez-Backhaus, J.M. Osca, A. Benedicto
Servicio de Urología, Unidad de Litotricia y Endourología, Hospital Universitario de La Ribera, Alzira, Valencia, Spain
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Tables (3)
Table 1. Preoperative and intraoperative data.
Table 2. Reasons for failure.
Table 3. Logistic regression.
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Abstract
Objective

To conduct a descriptive study of the implementation of greenlight laser photovaporization in a local hospital and to identify the ideal preoperative and intraoperative conditions to obtain a successful outcome.

Materials and methods

A retrospective review of 179 photovaporizations performed between January 2007 and June 2010 was performed. Preoperative data (age, prostate volume, PSA, IPSS, Qmax, medical history, ASA classification), intraoperative parameters (surgeon's experience, operating time, transfusion requirements, type of laser used, reconversion to transurethral resection of the prostate or TURP) and post-operative data (post-op complications, post-op PSA, post-op IPS score, post-op Qmax and reoperations) were analyzed.

We performed a univariate and multivariate analysis to identify which preoperative and intraoperative parameters influence therapeutic failure.

Results

The descriptive study shows similarity in all parameters compared to the available literature. In the multivariate analysis, it was found that the surgeon's experience and prostate volume over 40cc were independent predictive factors for success of greenlight laser photovaporization.

Conclusions

Greenlight laser photovaporization is an effective and reproducible procedure for treating lower urinary tract obstruction due to benign prostatic hyperplasia (BPH). Multicenter, prospective and randomized studies are needed to confirm the results of this study. There are few studies available in the literature that provide a high level of evidence and grade of recommendation.

Keywords:
Benign prostatic hyperplasia
Greenlight laser
Predictive success factors
Resumen
Objetivo

Realizar un estudio descriptivo de la implantación de la fotovaporización con láser verde en un hospital comarcal y determinar cuáles son las condiciones preoperatorias e intraoperatorias ideales para obtener un resultado satisfactorio.

Material y métodos

Revisión retrospectiva de 179 fotovaporizaciones realizadas entre enero de 2007 y junio de 2010, analizando datos preoperatorios (edad, volumen prostático, PSA, IPSS, Qmáx, antecedentes médicos y clasificación ASA) parámetros intraoperatorios (experiencia del cirujano, tiempo quirúrgico, requerimientos transfusionales, tipo de láser utilizado y reconversión a RTU) y postoperatorios (complicaciones, PSA, IPSS y Qmáx postoperatorios y reintervenciones).

Realizamos estudio univariante y multivariante para identificar qué parámetros preoperatorios e intraoperatorios van a condicionar un fracaso terapéutico.

Resultados

En el estudio descriptivo se observa similitud en todos los parámetros respecto a la literatura disponible. En el estudio multivariante se identifica la experiencia del cirujano y el volumen prostático mayor de 40 cc como factores predictivos de éxito independientes para la fotovaporización con láser verde.

Conclusiones

La fotovaporización con láser verde es un procedimiento efectivo y reproducible en el tratamiento desobstructivo del tracto urinario inferior por hiperplasia benigna de próstata (HBP). Son necesarios estudios multicéntricos, prospectivos y aleatorizados para confirmar los resultados de este estudio. Son pocos los estudios disponibles en la literatura que aporten un nivel de evidencia y un grado de recomendación elevados.

Palabras clave:
Hiperplasia benigna de próstata
Láser verde
Factores predictivos de éxito

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