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Inicio Actas Urológicas Españolas (English Edition) Evaluating the effects of preoperative treatment with 5-alpha reductase inhibito...
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Vol. 48. Issue 2.
Pages 150-154 (March 2024)
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Vol. 48. Issue 2.
Pages 150-154 (March 2024)
Original article
Evaluating the effects of preoperative treatment with 5-alpha reductase inhibitors in holmium laser enucleation of the prostate
¿Tiene el tratamiento previo con inhibidores de la 5-alfa reductasa repercusión en la enucleación prostática con láser holmium? Resultados de un estudio prospectivo observacional y revisión de la literatura
R. Bultó Gonzalvo
Corresponding author
, M. Bernardello Ureta, J. Cervera Alcaide, M. Sanchez Rodriguez, M. Franco, R. Freixa Sala, J. Areal Calama, F. Agreda Castañeda
Servicio de Urología, Hospital Universitari Germans Trias I Pujol, Badalona, Barcelona, Spain
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Tables (3)
Table 1. Preoperative baseline characteristics of the population.
Table 2. Peri- and postoperative outcomes in HoLEP.
Table 3. Literature review of the effects of 5-ARIs on surgical efficiency and bleeding in patients treated with HoLEP.
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Abstract
Introduction and aim

Patients treated with HoLEP are frequently treated with previous treatments, including 5-alpha-reductase inhibitors (5-ARIs). We investigated the impact of pretreatment with 5-ARIs on perioperative and immediate postoperative parameters in patients treated with HoLEP.

Material and methods

A retrospective study was performed using a prospectively collected database including all patients treated with HoLEP at our center between January 2017 and January 2023. The resected tissue weight, enucleation and morcellation efficiency (enucleation weight/time and morcellation weight/ time), postoperative complications, hospital stay and hemoglobin drop have been analyzed.

Results

A total of 327 patients were included. Of these, 173 (52.9%) were treated with 5-ARIs. No differences were found among the perioperative parameters investigated to determine efficiency. No differences were observed in peri- or postoperative complications, hospital stay or hemoglobin drop.

Conclusions

Therapy with 5-ARIs had no impact on the immediate postoperative outcomes of patients treated with HoLEP. In our cohort, we observed that the use of 5-ARIs did not affect surgical efficiency, enucleation or morcellation. Further multicenter studies will be necessary to validate these findings.

Keywords:
5-alpha-reductase inhibitors
Holmium laser enucleation of the prostate
Benign prostatic hyperplasia
Surgery
Resumen
Introducción y objetivos

Los pacientes tratados con HoLEP, frecuentemente han recibido tratamientos previos, incluyendo los inhibidores de la 5-alfa-reductasa (5ARIs). Nuestro objetivo es evaluar el efecto del tratamiento previo con 5ARIs en los parametros perioperatorios y del postoperatorio immediato en pacientes tratados con HoLEP.

Materiales y Métodos

Se ha llevado a cabo un estudio retrospectivo, utilizando una base de datos recogida prospectivamente, de todos los pacientes tratados con HoLEP en nuestro centro entre enero de 2017 y enero de 2023· Se han analizado los gramos de resección, la eficiencia de enucleación y morcelación (gramos enucleados/tiempo de enucleación y gramos de morcelación/tiempo de morcelación), las complicaciones postoperatorias, el tiempo de hospitalización y el descenso de hemoglobin.

Resultados

Se han incluido 327 pacientes· 173 de ellos (52,9%) fueron tratados con 5ARIs. Entre los parametros perioperatorios estudiados para determinar la eficiencia no se encontraron diferencias· No se observaron diferencias en las complicaciones peri o postoperatorias, estancia hospitalaria o descenso de hemoglobin.

Conclusiones

El uso de 5ARIs no tuvo repercusión en el postoperatorio immediato de los pacientes tratados con HoLEP· En nuestra cohorte, el uso de 5ARIs no ha demostrado alterar la eficiencia quirurgica, ni en la enucleación ni en la morcelación. Futuros estudios multicentricos serán necesarios para corroborar estos hallazgos.

Palabras clave:
Inhibidores de la 5-alfa reductasa
Enuncleación prostática con láser de holmium
Hiperplasia benigna de próstata
Cirugía

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