HoLEP provides a higher prostate cancer detection rate compared to bipolar TURP: a matched-pair analysis

Rosenhammer, Bernd and Lausenmeyer, Eva M. and Mayr, Roman and Burger, Maximilian and Eichelberg, Christian (2018) HoLEP provides a higher prostate cancer detection rate compared to bipolar TURP: a matched-pair analysis. WORLD JOURNAL OF UROLOGY, 36 (12). pp. 2035-2041. ISSN 0724-4983, 1433-8726

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Abstract

PurposeHolmium laser enucleation of the prostate (HoLEP) has become a popular alternative to TURP for desobstructive prostate surgery. The prevalence of incidental prostate cancer (iPCa) during surgery varies depending on many preoperative factors. To evaluate whether the surgical procedure itself (HoLEP vs. TURP) influences iPCa detection, we performed a case-by-case matched-pair analysis.MethodsPreoperative patient age, total PSA, and prostate volume were used as matching criteria. Descriptive statistics were used to confirm matching quality. Parameters were analyzed by Fisher's exact test and T test or Mann-Whitney U test for dichotomous and continuous variables, respectively. Uni- and multivariate logistic regression analyses were performed to identify predictors for iPCa detection.Results60 out of 136 patients after HoLEP and 60 out of 1220 patients after bipolar TURP (bTURP) could be included. Mean patient age was 71.5 and 70.3years in the HoLEP and bTURP group, respectively. Median preoperative total PSA was 4.42ng/ml for HoLEP and 4.33ng/ml for bTURP patients. Median preoperative prostate volume was 75.0cc in both groups. Mean percentage of tissue removed by HoLEP and bTURP was 63.5 and 49.5% (p<0.001), respectively. IPCa was found in 23.3% of HoLEP specimens compared to 8.3% in bTURP (p=0.043). PSA density was the only independent predictor for iPCa detection.ConclusionsIn this first matched-pair analysis, HoLEP provides a significantly higher iPCa detection rate than bTURP. This might be a result of a more efficient tissue removal during HoLEP. PSA density was the only independent risk factor for iPCa.

Item Type: Article
Uncontrolled Keywords: HOLMIUM LASER ENUCLEATION; MONOPOLAR TRANSURETHRAL RESECTION; FUNCTIONAL OUTCOMES; FOLLOW-UP; METAANALYSIS; DIAGNOSIS; T1A; Bipolar TURP; HoLEP; Incidental prostate cancer; Matched pairs
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Urologie
Depositing User: Dr. Gernot Deinzer
Date Deposited: 07 Oct 2019 13:34
Last Modified: 07 Oct 2019 13:35
URI: https://pred.uni-regensburg.de/id/eprint/13477

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