PurposeAlthough transurethral resection of the prostate (TURP) is considered the standard surgical treatment for benign prostatic hyperplasia (BPH), Holmium laser enucleation of the prostate (HoLEP) is replacing TURP. We compared TURP with HoLEP with matching for prostate size.Materials and MethodsWe retrospectively reviewed the medical charts of patients who underwent TURP and HoLEP performed by one surgeon at our institute. All patients were categorized into 3 groups on the basis of prostate size (group 1, <40 g; group 2, 40-79 g; and group 3, >80 g), and 45 patients were selected for each method.ResultsNo major intraoperative complications were encountered. The mean resected tissue weight was 6.3, 18.3, and 28.0 g for groups 1, 2, and 3, respectively, for TURP and 8.7, 25.0, and 39.8 g, respectively, for HoLEP. The mean operation time was 51.8, 89.3, and 101.9 minutes for TURP and 83.6, 122.8, and 131.2 minutes for HoLEP in groups 1, 2, and 3, respectively. HoLEP had better resection efficacy than TURP for any size prostate, but there was no statistical difference between the methods. Both methods resulted in an immediate and significant improvement of International Prostate Symptom Score, peak urinary flow rates, and postvoid residual urine volume.ConclusionsHoLEP is effective for BPH treatment, regardless of prostate size, even in a small prostate. The perioperative morbidity of HoLEP is also comparable to that of TURP.

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This study aimed to assess the prognostic value of computed tomography (CT)-attenuation and 18F-fluorodeoxyglucose (FDG) uptake of periprostatic adipose tissue (PPAT) for predicting disease progression-free survival (DPFS) in patients with prostate cancer. Seventy-seven patients with prostate cancer who underwent staging FDG positron emission tomography (PET)/CT were retrospectively reviewed. CT-attenuation (HU) and FDG uptake (SUV) of PPAT were measured from the PET/CT images. The relationships between these PPAT parameters and clinical factors were assessed, and a Cox proportional hazard regression test was performed to evaluate the prognostic significance of PPAT HU and SUV. PPAT HU and SUV showed significant positive correlations with tumor stage and serum prostate-specific antigen level (PSA) (p < 0.05). Patients with high PPAT HU and SUV had significantly worse DPFS than those with low PPAT HU and SUV (p < 0.05). In multivariate analysis, PPAT SUV was a significant predictor of DPFS after adjusting for tumor stage, serum PSA, and tumor SUV (p = 0.003; hazard ratio, 1.50; 95% confidence interval, 1.15–1.96). CT-attenuation and FDG uptake of PPAT showed significant association with disease progression in patients with prostate cancer. These imaging findings may be evidence of the role of PPAT in prostate cancer progression.

Background Several approaches for urethral catheterization after the failure of initial urethral catheterization have been introduced. However, standard procedures regarding what should be done after failed conventional urethral catheterization have been not established. Therefore, we investigated the clinical efficacy of retrograde urethrography (RGU)-assisted urethral catheterization after failed conventional urethral catheterization. Methods Between July 2015 and July 2018, 136 patients who underwent RGU-assisted urethral catheterization after failed conventional urethral catheterization were included in this retrospective study. Patients’ clinical data, such as age, catheterization site, and previous history of urologic operations, were collected and assessed via chart review. Univariate and multivariate logistic regression analyses were performed to identify predictive factors for the failure of this procedure. Results Of the 136 patients, 94 (69.1%) experienced successful RGU-assisted urethral catheterization. Having a previous history of urologic operations, such as urethrotomy and transurethral prostatectomy, was identified as an independent predictive factor for the failure of RGU-assisted urethral catheterization (odds ratio = 9.453, 95% confidence interval = 2.703–33.063, p < 0.001). Conclusions RGU-assisted urethral catheterization can be one of the modalities for providing successful catheterization after failed conventional urethral catheterization. We believe that RGU-assisted urethral catheterization can be an effective procedure if patients have no previous history of urologic operations, such as urethrotomy and transurethral prostatectomy. Trial registration Soonchunhyang university institutional review board approval (No. 2018-08-021).