Laser treatment of benign prostatic hyperplasia in patients on oral anticoagulant therapy: a review

Descazeaud, A.; Robert, G.; Azzousi, Abdel Rahmene; Ballereau, Charles; Lukacs, B.; Haillot, O.; Dumonceau, O.; Devonec, M.; Fourmarier, M.; Saussine, C.; Taille, Alexandre de la

doi:10.1111/j.1464-410x.2008.08284.x

Cited by 32 publications

(23 citation statements)

References 22 publications

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“…GreenLight PVP laser showed positive results in several studies in the short and medium term in patients with LUTS secondary to BPO [2,3,4,5,10,11,12,13,15,20], including a better safety profile than monopolar TURP in patients on antiplatelet or anticoagulant treatment [6,7,8,21]. Very few published data tell us about the long-term outcome of PVP [1,4,11,12].…”

Section: Discussionmentioning

confidence: 99%

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Long-Term Outcomes of 80-Watt KTP and 120-Watt HPS GreenLight Photoselective Vaporization of the Prostate

Broggi¹,

May²,

Giretti³

et al. 2014

Urol Int

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Objective: Photoselective vaporization of the prostate (PVP) is becoming a surgical treatment alternative of transurethral resection of the prostate for male lower urinary tract symptoms (LUTS) secondary to benign prostatic obstruction (BPO). We evaluated the outcome and postoperative complications of PVP performed by 80-W KTP and 120-W HPS GreenLight lasers (AMS®) over a 4-year period. Materials and Methods: This is a prospective monocentric study that included all patients who underwent PVP. They had routine follow-up at 1 month, 3 months, 6 months and every year until the fourth postoperative year. Listed data were maximum urinary flow rate (Q_max), International Prostate Symptom Score (IPSS), post-void residual (PVR) volume, prostate-specific antigen (PSA) and prostate volume. We collected the postoperative complications. Results: From September 2005 to May 2008, 77 patients out of a 409 patients cohort underwent surgery and were followed during 4 years. At 4 years mean Q_max increase was 82.5%; mean IPSS, PVR volume, PSA and prostate volume decreases were 79.1, 69.8, 43.8 and 22.9%, respectively. The main side effects observed were storage LUTS. A urinary catheter was replaced after a first withdrawal failure in 10 patients (15.6%) after surgery. Conclusions: PVP showed a sustainable efficacy and an appealing tolerance profile during a 4-year period in patients with LUTS secondary to BPO.

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Section: Discussionmentioning

confidence: 99%

“…This technique is particularly useful in aging patients or patients with antiplatelet or anticoagulant treatment since it appears to better control the bleeding risk [6,7,8]. …”

Section: Introductionmentioning

confidence: 99%

Long-Term Outcomes of 80-Watt KTP and 120-Watt HPS GreenLight Photoselective Vaporization of the Prostate

Broggi¹,

May²,

Giretti³

et al. 2014

Urol Int

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“…Recent reviews have confirmed that photoselective vaporization of the prostate also has excellent hemostatic properties in these patients and the 2 modalities are probably equivalent in smaller prostates (up to 60 g). However, in larger prostates HOLEP is probably superior in safety, efficacy and time efficiency [14,23]. …”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have shown that HOLEP is at least as effective at improving obstructive symptoms with shorter hospitalization and catheter time and importantly less blood loss [10,11,12,13,14]. Two recent studies have supported the safety of HOLEP in anticoagulated patients [15,16].…”

Section: Introductionmentioning

confidence: 99%

Holmium Laser Enucleation of the Prostate: Comparison of Immediate Postoperative Outcomes in Patients with and without Antithrombotic Therapy

Bishop¹,

Liddell²,

Ischia³

et al. 2013

Current Urology

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Objective: To compare the immediate postoperative outcomes of patients with benign prostatic hyperplasia undergoing Holmium laser enucleation of the prostate (HOLEP) with and without full anticoagulation or antiplatelet therapy at the time of surgery. Materials and Methods: A retrospective review was performed on a series of consecutive patients undergoing HOLEP at our institution by a single surgeon from February 2004 to September 2010. Demographic, surgical, pathological and outcome data were collected. Two cohorts were identified on the basis of antithrombotic therapy at the time of surgery. Patients who continued on aspirin, aspirin/dipyridamole, clopidogrel and warfarin throughout the surgery were included in the antithrombotic cohort. Univariate analysis was performed to determine differences in outcomes between the 2 cohorts. Results: Total 125 consecutive patients underwent HOLEP with 52 patients on antithrombotic therapy at the time of surgery and 73 patients were not on antithrombotic therapy during surgery. Patients in the antithrombotic group were older (75.1 ±7.5 vs. 71.7 ± 8.3 years; p = 0.02) and had a higher median ASA physical status (3 (3-3) vs. 2 (2-3), p < 0.0001). The mean operating time and median specimen volume were not significantly different between the 2 cohorts. The median length of stay (2 (1-3) vs. 1 (1-2) d, p = 0.014) was longer in the antithrombotic cohort. The transfusion rate (7.7 vs. 0%, p = 0.028) was predictably higher in the antithrombotic cohort. No patients required re-operation for bleeding. Conclusions: The use of HOLEP in patients on antithrombotic therapy is safe despite the higher surgical risk profile of that particular patient population and the potential increased risk for significant bleeding.

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“…Holmium laser enucleation of prostate). On vrši vrlo dobru hemostazu zbog čega njime možemo sa sigurnošću liječiti pacijente koji su na antikoagulantnoj terapiji 22 . Laser valne duljine 532 nm, čiji je predstavnik KTP laser GreenLight TM , koji emitira kvazikontinuirani val, gotovo u potpunosti se apsorbira od strane hemoglobina, što rezultira fotoselektivnom vaporizacijom prostate PVP (engl.…”

Section: Laserske Tehnikeunclassified

Surgical management of benign prostatic hyperplasia

et al. 2017

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Sažetak. Nekada smo benignu hiperplaziju prostate smatrali glavnim uzrokom problema s mokrenjem kod muškaraca. Danas koristimo naziv simptomi donjeg urinarnog trakta jer se pokazalo kako je benigna hiperplazija prostate samo jedan od etioloških čimbenika. Kvalitetna dijagnostička obrada simptoma uputit će nas u pravom smjeru kako bismo mogli individualizirati terapiju. Za pacijente koji imaju indikaciju za kirurško liječenje danas postoji nekoliko operativnih tehnika. Otvorena jednostavna prostatektomija najstariji je i dokazano učinkoviti zahvat. Transuretralna resekcija prostate je zlatni standard liječenja. Laserska tehnologija danas stoji uz bok zlatnom standardu, a pojavile su se i tehnike minimalno invazivne kirurgije koje pružaju prednosti niskog morbiditeta i kratkotrajne hospitalizacije.Ključne riječi: minimalno invazivna kirurgija; povećanje prostate; prostatektomija; transuretralna resekcija prostate Abstract. Benign prostatic hyperplasia was once considered the main reason for urinary symptoms in male patients. Today we are aware that many etiological factors cause these symptoms so a new term was coined: lower urinary tract symptoms. An adequate diagnostic work up will lead us onto the right path of individualized treatment for each patient. Those in need of surgery have various surgical procedures at their disposal. Open simple prostatectomy is the oldest procedure that has proven its efficacy. Transurethral resection of prostate is the current gold standard. Laser techniques are challenging the gold standard while minimally invasive surgical procedures offer all the benefits of low morbidity and short hospital stay.

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Laser treatment of benign prostatic hyperplasia in patients on oral anticoagulant therapy: a review

Cited by 32 publications

References 22 publications

Long-Term Outcomes of 80-Watt KTP and 120-Watt HPS GreenLight Photoselective Vaporization of the Prostate

Long-Term Outcomes of 80-Watt KTP and 120-Watt HPS GreenLight Photoselective Vaporization of the Prostate

Holmium Laser Enucleation of the Prostate: Comparison of Immediate Postoperative Outcomes in Patients with and without Antithrombotic Therapy

Surgical management of benign prostatic hyperplasia

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