Functional Outcome and Safety of Endoscopic Treatment Options for Benign Prostatic Obstruction (BPO) in Patients ≥ 75 Years of Age

Author:

Deininger Susanne1ORCID,Dieplinger Anna Maria2,Lauth Wanda3,Lusuardi Lukas1ORCID,Törzsök Peter14ORCID,Oswald David1,Pallauf Maximilian1,Eiben Christian1,Peters Julia1,Erne Eva5ORCID,Zangl Quirin6,Deininger Christian78,Ramesmayer Christian1ORCID

Affiliation:

1. Department of Urology and Andrology, Salzburg University Hospital, Paracelsus Medical University, 5020 Salzburg, Austria

2. Institute for Nursing Science and Practice, Paracelsus Medical University, 5020 Salzburg, Austria

3. Team Biostatistics and Big Medical Data, IDA Lab Salzburg, Paracelsus Medical University Salzburg, Strubergasse 16, 5020 Salzburg, Austria

4. Faculty of Health and Sport Sciences, Széchenyi István University, 9026 Györ, Hungary

5. Department of Urology, Eberhard Karls University, 72076 Tübingen, Germany

6. Department of Neuroanesthesia, Christian Doppler Hospital, Paracelsus Medical University, 5020 Salzburg, Austria

7. Department of Orthopedics and Traumatology, Salzburg University Hospital, Paracelsus Medical University, 5020 Salzburg, Austria

8. Institute of Tendon and Bone Regeneration, Paracelsus Medical University, Spinal Cord Injury & Tissue Regeneration Center Salzburg, 5020 Salzburg, Austria

Abstract

Background: The selection of suitable patients for the surgical treatment of benign prostatic obstruction (BPO) is a challenge in persons ≥75 years of age. Methods: After a systematic literature search of PubMed, 22 articles were included in this review. Clinical and functional parameters were evaluated statistically. Results: The mean age of the patients was ≥79 years. The mean duration of postoperative catheterization ranged between 2 (d) (ThuLEP, thulium laser enucleation of the prostate) and 4.4 days (TURP, transurethral resection of the prostate). Complication rates ranged between 6% (HoLAP, holmium laser ablation of the prostate) and 34% (PVP, photoselective vaporization of the prostate); the maximum rate of severe complications was 4% (TURP). The mean postoperative maximal urinary flow (Qmax) in mL/sec. ranged between 12.9 mL/sec. (HoLAP) and 19.8 mL/sec (Hol-TUIP, holmium laser transurethral incision of the prostate). The mean quality of life (QoL) score fell from 4.7 ± 0.9 to 1.8 ± 0.7 (HoLEP), from 4.1 ± 0.4 to 1.9 ± 0.8 (PVP), from 5.1 ± 0.2 to 2.1 ± 0.2 (TURP), and from 4 to 1 (ThuVEP, thulium laser vapoenucleation of the prostate). Pearson’s correlation coefficient (r) revealed a positive linear correlation between age and inferior functional outcome (higher postoperative International Prostate Symptom Score (IPSS) [r = 0.4175]), higher overall complication rates (r = 0.5432), and blood transfusions (r = 0.4474) across all surgical techniques. Conclusions: This meta-analysis provides the summary estimates for perioperative and postoperative functional outcome and safety of endoscopic treatment options for BPO in patients ≥ 75 years of age. Of particular importance is that all surgical techniques significantly improve the postoperative quality of life of patients in this age group compared to their preoperative quality of life.

Publisher

MDPI AG

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