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08.01.2018 | Original Article | Ausgabe 3/2018

Lasers in Medical Science 3/2018

Benign prostatic hyperplasia surgical scoring (BPHSS): an novel scoring system for the perioperative outcomes of holmium laser enucleation of the prostate

Zeitschrift:
Lasers in Medical Science > Ausgabe 3/2018
Autoren:
Huan Xu, Zhikang Cai, Yanbo Chen, Meng Gu, Qi Chen, Zhong Wang
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s10103-017-2425-1) contains supplementary material, which is available to authorized users.
Huan Xu and Zhikang Cai contributed equally to this work.
Whether the paper is based on a previous communication to a society or meeting: No
Trial registration: ChiCTR-OOC-16008455

Abstract

To develop a standardized scoring system, the BPH surgical scoring (BPHSS) system, to quantify the ability to predict the perioperative outcomes resulting from an enlarged prostate. There are two parts included in this study: the retrospective observational study (875 patients treated with holmium laser enucleation of the prostate, HoLEP) and the prospective observational study (111 patient underwent HoLEP). All the outcome data included the following: the basic patient preoperative characteristics, operation time (OT), pre- and post- surgery hemoglobin decrease, Na+ variation, hospital stay duration, duration of bladder irrigation, catheterization time, and hospitalization time. The BPHSS, consisting of prostatic volume (PV), prostate-specific antigen (PSA), bladder stones, intravesical prostatic protrusion (IPP), and metabolic syndrome (MetS), was observed regarding the perioperative outcomes. In the retrospective study, patients in high BPHSS group (6–8 points) showed significant increase in the OT (74.61, 95%CI = 16.98–327.84, P < 0.001), hemochrome reduction (416.50, 95%CI = 35.48–4889.88, P < 0.001), hospital stay (1.80, 95%CI = 1.35–2.41, P < 0.001), and bladder irrigation duration (4.04, 95%CI = 1.35–12.10, P = 0.013) compared with the low BPHSS group (0–2 points). In the prospective study, there also existed significant differences between the three scoring grades (P < 0.01) in OT, hemochrome decrease, and the hospital stay. The BPHSS is suitable to predict the perioperative outcomes in patients undergoing HoLEP. It may help urologist to prepare more before surgery to treat the enlarged prostates. Further studies are needed to validate this scoring system in BPH patients in multiple centers.

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