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array:24 [ "pii" => "S2173578613000310" "issn" => "21735786" "doi" => "10.1016/j.acuroe.2012.03.014" "estado" => "S300" "fechaPublicacion" => "2013-01-01" "aid" => "425" "copyright" => "AEU" "copyrightAnyo" => "2011" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2013;37:20-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 800 "formatos" => array:3 [ "EPUB" => 8 "HTML" => 623 "PDF" => 169 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0210480612001088" "issn" => "02104806" "doi" => "10.1016/j.acuro.2012.03.004" "estado" => "S300" "fechaPublicacion" => "2013-01-01" "aid" => "425" "copyright" => "AEU" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2013;37:20-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1921 "formatos" => array:3 [ "EPUB" => 11 "HTML" => 1524 "PDF" => 386 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Artículo original</span>" "titulo" => "Análisis de factores predictivos de éxito para la fotovaporización próstatica en hiperplasia benigna de próstata mediante láser verde" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "20" "paginaFinal" => "24" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Analysis of Predictive Factors of Success for Prostate Photovaporization in Benign Prostatic Hyperplasia by Greenlight Laser" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 333 "Ancho" => 1549 "Tamanyo" => 48644 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Evolución del flujo miccional. Se observa una mejoría estadísticamente significativa entre el Q<span class="elsevierStyleInf">máx</span> medio preoperatorio y los controles a los 3, 6, 9 y 12 meses poscirugía (p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,001).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J. Miralles, J.L. Palmero, M. Ramírez-Backhaus, J.M. Osca, A. Benedicto" "autores" => array:5 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Miralles" ] 1 => array:2 [ "nombre" => "J.L." "apellidos" => "Palmero" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Ramírez-Backhaus" ] 3 => array:2 [ "nombre" => "J.M." "apellidos" => "Osca" ] 4 => array:2 [ "nombre" => "A." 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Gómez-Sancha" "autores" => array:1 [ 0 => array:2 [ "nombre" => "F." "apellidos" => "Gómez-Sancha" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0210480612001672" "doi" => "10.1016/j.acuro.2012.05.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480612001672?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578613000322?idApp=UINPBA00004N" "url" => "/21735786/0000003700000001/v1_201306251136/S2173578613000322/v1_201306251136/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173578613000309" "issn" => "21735786" "doi" => "10.1016/j.acuroe.2012.06.002" "estado" => "S300" "fechaPublicacion" => "2013-01-01" "aid" => "460" "copyright" => "AEU" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2013;37:12-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1298 "formatos" => array:3 [ "EPUB" => 13 "HTML" => 1035 "PDF" => 250 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "National Prostate Cancer Registry 2010 in Spain" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "12" "paginaFinal" => "19" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Registro nacional de cáncer de próstata 2010 en España" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1809 "Ancho" => 2632 "Tamanyo" => 256047 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Frequency of cylinders taken per biopsy.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.M. Cózar, B. Miñana, F. Gómez-Veiga, A. Rodríguez-Antolín, H. Villavicencio, A. Cantalapiedra, E. Pedrosa" "autores" => array:7 [ 0 => array:2 [ "nombre" => "J.M." "apellidos" => "Cózar" ] 1 => array:2 [ "nombre" => "B." "apellidos" => "Miñana" ] 2 => array:2 [ "nombre" => "F." "apellidos" => "Gómez-Veiga" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Rodríguez-Antolín" ] 4 => array:2 [ "nombre" => "H." "apellidos" => "Villavicencio" ] 5 => array:2 [ "nombre" => "A." "apellidos" => "Cantalapiedra" ] 6 => array:2 [ "nombre" => "E." "apellidos" => "Pedrosa" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0210480612002501" "doi" => "10.1016/j.acuro.2012.06.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480612002501?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578613000309?idApp=UINPBA00004N" "url" => "/21735786/0000003700000001/v1_201306251136/S2173578613000309/v1_201306251136/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Analysis of predictive factors of success for prostate photovaporization in benign prostatic hyperplasia by greenlight laser" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "20" "paginaFinal" => "24" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J. Miralles, J.L. Palmero, M. Ramírez-Backhaus, J.M. Osca, A. Benedicto" "autores" => array:5 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Miralles" ] 1 => array:4 [ "nombre" => "J.L." "apellidos" => "Palmero" "email" => array:1 [ 0 => "joseluispalmer@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Ramírez-Backhaus" ] 3 => array:2 [ "nombre" => "J.M." "apellidos" => "Osca" ] 4 => array:2 [ "nombre" => "A." "apellidos" => "Benedicto" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Urología, Unidad de Litotricia y Endourología, Hospital Universitario de La Ribera, Alzira, Valencia, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Análisis de factores predictivos de éxito para la fotovaporización próstatica en hiperplasia benigna de próstata mediante láser verde" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 333 "Ancho" => 1549 "Tamanyo" => 48535 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Evolution of the urinary flow. There is a statistically significant improvement between the mean preoperative <span class="elsevierStyleItalic">Q</span><span class="elsevierStyleInf">max</span> and the controls at 3, 6, 9, and 12 months after the surgery (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">In the historical evolution of the surgical treatment of benign prostatic hyperplasia (BPH), we can observe how minimally invasive techniques have imposed to open surgery, with a higher rate of complications.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Among these techniques, prostate photovaporization with greenlight laser has shown a safe, effective option with few complications, especially useful for anticoagulated patients or with high comorbidity, due to their little bleeding and reduced probe and hospital stay time.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Since there are not many studies in the literature that evaluate the predictors of success of prostate photovaporization, we performed a descriptive study of the series of patients operated in our prostate unblocking surgery center by greenlight laser photovaporization, and we tried to determine if there are preoperative or intraoperative variables that can determine the success of unblocking surgery by means of a univariate and multivariate study.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Material and methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">We performed a retrospective review of the patients undergoing greenlight laser photovaporization. The energy sources used were generators of potassium-titanyl-phosphate 80<span class="elsevierStyleHsp" style=""></span>W KTP (GreenLight PV, AMS) and lithium triborate HPS 120<span class="elsevierStyleHsp" style=""></span>W (GreenLight PV AMS).</p><p id="par0025" class="elsevierStylePara elsevierViewall">We analyzed a total of 179 operations performed between January 2007 and June 2010, in which 9 surgeons were involved.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The inclusion criteria considered for the prostate photovaporization were the following:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">•</span><p id="par0035" class="elsevierStylePara elsevierViewall">Maximum flow (<span class="elsevierStyleItalic">Q</span><span class="elsevierStyleInf">max</span>)<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>15<span class="elsevierStyleHsp" style=""></span>ml/s.</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">•</span><p id="par0040" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">International Prostate Symptom Score</span> (IPSS)<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>7 or <7 with objective obstruction parameters.</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">•</span><p id="par0045" class="elsevierStylePara elsevierViewall">PSA<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>4 or PSA<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>ng/ml with previous negative prostate biopsy (10 cylinders).</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">•</span><p id="par0050" class="elsevierStylePara elsevierViewall">Ultrasound prostate volume<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>30<span class="elsevierStyleHsp" style=""></span>ml.</p></li></ul></p><p id="par0055" class="elsevierStylePara elsevierViewall">All the patients underwent complete anamnesis including IPSS, general examination, and DRE. The study was complemented by urological ultrasound and PSA.</p><p id="par0060" class="elsevierStylePara elsevierViewall">The following parameters were evaluated: surgeon's experience, age, prostate volume, preoperative and postoperative serum PSA, IPSS preoperatively and at 3 months, flowmetry preoperatively and at 3, 6, 9, and 12 months, urological and medical history, ASA classification, surgical time, and intraoperative complications.</p><p id="par0065" class="elsevierStylePara elsevierViewall">We defined as success of surgery: lack of conversion to another technique, improvement in the IPSS score, and lack of reoperation (incontinence, persistent LUTS, etc.).</p><p id="par0070" class="elsevierStylePara elsevierViewall">A descriptive analysis was performed with the variables under study. Subsequently, a univariate study was carried out determining which variables cause the success of the procedure by the Chi-square, Cramer's V, and Fisher tests for qualitative variables, and Student's <span class="elsevierStyleItalic">t</span>, Wilcoxon, and logistic regression for quantitative variables (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.05). Finally, we carried out a logistic regression with the statistically significant parameters in the univariate analysis to determine independent predictors of success. The SPSS v.15 statistical package was used.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Results</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Descriptive study</span><p id="par0075" class="elsevierStylePara elsevierViewall">179 surgeries were performed in which 9 surgeons of the Department took part. The number of surgeries performed by each one ranged between 65 and 3 interventions, with a mean age of 67.97 years (66.69–69.24). The mean ultrasound volume was 45.72<span class="elsevierStyleHsp" style=""></span>cc (43.78–57.66). The mean preoperative PSA was 2.55<span class="elsevierStyleHsp" style=""></span>ng/ml (95% CI: 2.18–2.92<span class="elsevierStyleHsp" style=""></span>ng/ml). The median IPSS was 20 points, 7% of the patients showing mild symptoms, 45.7% moderate symptoms, and 53% severe symptoms. The included patients with mild IPSS present objective signs of infravesical obstruction, such as very low <span class="elsevierStyleItalic">Q</span><span class="elsevierStyleInf">max</span>, high postvoid residual, bladder stones, or associated urinary tract infections. The mean preoperative <span class="elsevierStyleItalic">Q</span><span class="elsevierStyleInf">max</span> was 7.39 (6.94–7.84) and had a postoperative evolution at 3, 6, 9, and 12 months as shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> and <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">The median postvoid residual was 172.55<span class="elsevierStyleHsp" style=""></span>cc. The distribution according to the ASA classification was: I (5%), II (60.3%), III (31.8), and IV (2.8%). The median follow-up was 9 months (4–32 months).</p><p id="par0085" class="elsevierStylePara elsevierViewall">The intraoperative, postoperative, and follow-up parameters are described in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>. According to the definition of treatment failure raised in the methodology, in 30 cases (16.8%) the result was not satisfactory (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Univariate analysis</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Experience of the surgeon</span><p id="par0090" class="elsevierStylePara elsevierViewall">Better results were observed as the surgeon's experience increased (logistic regression: <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.02; OR<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.068).</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Age of the patients</span><p id="par0095" class="elsevierStylePara elsevierViewall">Dividing the patients into 3 age groups (<60, 60–70, and >70 years) showed no statistically significant differences in the outcome of the surgery in terms of age (V Cramer; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.985).</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Ultrasound volume</span><p id="par0100" class="elsevierStylePara elsevierViewall">Better results were observed with larger prostates (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.02; OR<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.048).</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Preoperative prostate specific antigen</span><p id="par0105" class="elsevierStylePara elsevierViewall">The patients were divided into 2 groups (PSA<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>ng/dl, and PSA<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>ng/dl), observing statistically significant differences (Chi-square; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.032); in the normal PSA range group, a higher success rate of the surgery (86%) was observed compared to the doubtful-pathological range group (72.7%).</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Preoperative International Prostate Symptom Score</span><p id="par0110" class="elsevierStylePara elsevierViewall">The patients with mild and moderate symptoms were grouped on the one side and the patients with severe symptoms on the another side, obtaining a success rate of 87.7 and 80.7%, finding no statistically significant differences (Chi-square; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.229).</p><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Urological and medical history and classification of the American Society of Anesthesiologists</span><p id="par0115" class="elsevierStylePara elsevierViewall">An inferential study was carried out showing no differences in the success of the surgery depending on the presence or absence of urological or medical history (Chi-square; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.55 and <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.978, respectively).</p><p id="par0120" class="elsevierStylePara elsevierViewall">No differences were evidenced in the outcome of the surgery according to the ASA classification (Cramer's V <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.9).</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Peak flow</span><p id="par0125" class="elsevierStylePara elsevierViewall">The peak flow did not condition the result of the surgery (logistic regression; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.191).</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Greenlight laser used</span><p id="par0130" class="elsevierStylePara elsevierViewall">2 types of devices were used throughout the series. The first 86 interventions were carried out with the 80<span class="elsevierStyleHsp" style=""></span>W KTP, later moving to the 120<span class="elsevierStyleHsp" style=""></span>W laser, with success rates of 77.7 and 87.7%, respectively, but this difference was not statistically significant (Chi-square<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.75). There were differences indeed in the surgical time, being significantly shorter in the 120<span class="elsevierStyleHsp" style=""></span>W group (52 [±17]) vs. 44.79<span class="elsevierStyleHsp" style=""></span>min (±13.1; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.02), although the prostate volume was significantly higher in the 120<span class="elsevierStyleHsp" style=""></span>W group (48.18<span class="elsevierStyleHsp" style=""></span>cc [±2.7] vs. 42.6<span class="elsevierStyleHsp" style=""></span>cc [±2.61]).</p></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Multivariate model</span><p id="par0135" class="elsevierStylePara elsevierViewall">After the univariate analysis, we got 3 variables in which there were differences in the outcome between subgroups:<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">1.</span><p id="par0140" class="elsevierStylePara elsevierViewall">The surgeon's experience: the greater the experience, the higher the success rate of the surgery.</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">2.</span><p id="par0145" class="elsevierStylePara elsevierViewall">Ultrasound volume: the larger the prostate volume, the higher the success rate of the surgery.</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">3.</span><p id="par0150" class="elsevierStylePara elsevierViewall">PSA: the higher the PSA level, the higher the failure rate of the surgery.</p></li></ul></p><p id="par0155" class="elsevierStylePara elsevierViewall">We performed a logistic regression, including the 3 variables that were statistically significant in the univariate model.</p><p id="par0160" class="elsevierStylePara elsevierViewall">We only identified as an independent factor of success the surgeon's experience with a 1.067 OR (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.014). The results are shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>.</p></span></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discussion</span><p id="par0165" class="elsevierStylePara elsevierViewall">The use of new technologies for the surgical treatment of BPH should be evaluated by conducting retrospective, prospective randomized studies, and subsequent meta-analyses, evaluating the safety, efficacy, and reproducibility of the processes.</p><p id="par0170" class="elsevierStylePara elsevierViewall">The TUR and open surgery are currently considered the gold standard for prostates smaller than 80<span class="elsevierStyleHsp" style=""></span>cc and greater than 100<span class="elsevierStyleHsp" style=""></span>cc, respectively.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>The greenlight laser already has enough experience to be recommended for the treatment of BPH, due to its better intraoperative complication rate compared to the TUR (LE3, RG B),<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a> especially in patients at high risk of bleeding. The oldest, and therefore with more articles in the literature, is the 80<span class="elsevierStyleHsp" style=""></span>W KTP laser, and since Malek published the first results in humans in 1998,<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> its use has been increasing.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> It drags the problem of the vaporization rate of the prostate tissue, significantly slower than in the TUR.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,6</span></a> In contrast, in the randomized studies comparing the 120<span class="elsevierStyleHsp" style=""></span>W laser to the TUR-p, there was no consensus; while the group of Al-Ansari observed significantly lower operative times with TUR-P, Capitán et al. found no statistically significant differences.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> Only a randomized study comparing the HPS 120<span class="elsevierStyleHsp" style=""></span>W laser to open surgery, with shorter surgical times for the endourologic procedure, fewer transfusion requirements, shorter time of probe and hospital stay, without any differences in functional outcomes.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> We studied the vaporization rate of both lasers, noting that the HPS laser has a vaporization rate of 7.01<span class="elsevierStyleHsp" style=""></span>g/10<span class="elsevierStyleHsp" style=""></span>min versus the 3.99<span class="elsevierStyleHsp" style=""></span>g/10<span class="elsevierStyleHsp" style=""></span>min of the KTP laser.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> In our series, the median surgical time was 45<span class="elsevierStyleHsp" style=""></span>min, significantly shorter in the group operated with the 120<span class="elsevierStyleHsp" style=""></span>W laser for an ultrasound volume of 45.72<span class="elsevierStyleHsp" style=""></span>cc (95%CI<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>43.78–57.66), within the range described in the literature, between 32 and 132<span class="elsevierStyleHsp" style=""></span>min.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,5–8</span></a>Our sample does not differ with respect to preoperative or intraoperative parameters (<span class="elsevierStyleItalic">Q</span><span class="elsevierStyleInf">max</span>, IPSS, prostate volume, surgical time, hospital stay, and days of catheterization, transfusion requirements, etc.) compared to previous publications.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,5–8</span></a></p><p id="par0175" class="elsevierStylePara elsevierViewall">Early postoperative complications were very scarce (3%), as only 2 cases of readmission for non-tractable hematuria and 2 cases of urinary sepsis were reported, which resolved with conservative treatment.</p><p id="par0180" class="elsevierStylePara elsevierViewall">It is worth stressing the hospital stay and probing time, which in our series showed a median of one day in both variables, and no red blood cell transfusions were required in any case, which makes photovaporization the technique of choice in patients at high surgical risk.</p><p id="par0185" class="elsevierStylePara elsevierViewall">A total of 15 reoperations were recorded (7 cases of persistent BPH, 5 cases of cell sclerosis, and 2 cases of minimal effort incontinence that required artificial sphincter) and represent 9% of all procedures. According to the recommendations of the International Greenlight Laser Users Group (IGLU), the long-term results are still unable to be determined due to the absence of works that support them.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,10</span></a></p><p id="par0190" class="elsevierStylePara elsevierViewall">In the second part of the work, which attempts to identify the determinants of a successful outcome of the photovaporization, there is no consensus in the literature. There are few studies that attempt to determine them and there is no consensus on the definition of success. In our group, strict success criteria were established (need for reconversion, lack of improvement in the IPSS questionnaire, and obviously need for reintervention, either due to remains of obstructive prostate tissue, or cell sclerosis or incontinence).</p><p id="par0195" class="elsevierStylePara elsevierViewall">High surgical experience was established as a success factor. The prostate volume does not seem to be determinant of the outcome. Gu et al. studied the impact of the prostate volume on the postoperative outcome, finding no differences in the AUA-SI, quality of life, <span class="elsevierStyleItalic">Q</span><span class="elsevierStyleInf">max</span>, and postvoid residual in large prostates.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">11</span></a> There is a study that suggests the low detrusor contractility as a risk factor of dissatisfaction.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> Unfortunately, in our protocol we have not performed a urodynamic study to evaluate this issue. In another study, the association with postoperative irritative symptoms with low scores in the AUA-SI and treatment with finasteride was suggested.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> Other risk factors for worsening of the outcomes are identified in the literature as PSAt<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>6<span class="elsevierStyleHsp" style=""></span>ng/ml,<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> a result which is also statistically significant in our sample in the univariate study, although it does not achieve significance in the multivariate analysis. This study also assesses the impact of the prostate volume on the outcome of the procedure. They achieve improvements in the <span class="elsevierStyleItalic">Q</span><span class="elsevierStyleInf">max</span> and AUA symptom questionnaire in all the prostate volume groups, but without differences between the groups, as seen in our study.</p><p id="par0200" class="elsevierStylePara elsevierViewall">The results are not influenced by the laser power in our series. Now, the subgroups operated with the 80 and 120<span class="elsevierStyleHsp" style=""></span>W laser are not comparable, because the experience of the surgeons and the prostate volume was greater in the 120<span class="elsevierStyleHsp" style=""></span>W group.</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conclusions</span><p id="par0205" class="elsevierStylePara elsevierViewall">The greenlight laser photovaporization is an increasingly present technique in the Urology Departments. The technological development, with the introduction of more powerful lasers with the same safety profile, allows for this technique to be a safe procedure, with results comparable to the current gold standard, regardless of preoperative objective and subjective parameters, except for the surgical experience. They offer a clear advantage over the classical unblocking techniques in terms of operative bleeding, probing days, and hospital stay.</p><p id="par0210" class="elsevierStylePara elsevierViewall">Prospective comparative studies that attempt to identify the predictive factors to obtain a successful outcome to ratify the results obtained in this work are required.</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflict of interest</span><p id="par0215" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:2 [ "identificador" => "xres191952" "titulo" => array:5 [ 0 => "Abstract" 1 => "Objective" 2 => "Materials and methods" 3 => "Results" 4 => "Conclusions" ] ] 1 => array:2 [ "identificador" => "xpalclavsec179178" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres191953" "titulo" => array:5 [ 0 => "Resumen" 1 => "Objetivo" 2 => "Material y métodos" 3 => "Resultados" 4 => "Conclusiones" ] ] 3 => array:2 [ "identificador" => "xpalclavsec179177" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Material and methods" ] 6 => array:3 [ "identificador" => "sec0015" "titulo" => "Results" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0020" "titulo" => "Descriptive study" ] 1 => array:3 [ "identificador" => "sec0025" "titulo" => "Univariate analysis" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0030" "titulo" => "Experience of the surgeon" ] 1 => array:2 [ "identificador" => "sec0035" "titulo" => "Age of the patients" ] 2 => array:2 [ "identificador" => "sec0040" "titulo" => "Ultrasound volume" ] 3 => array:2 [ "identificador" => "sec0045" "titulo" => "Preoperative prostate specific antigen" ] ] ] 2 => array:3 [ "identificador" => "sec0050" "titulo" => "Preoperative International Prostate Symptom Score" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0055" "titulo" => "Urological and medical history and classification of the American Society of Anesthesiologists" ] 1 => array:2 [ "identificador" => "sec0060" "titulo" => "Peak flow" ] 2 => array:2 [ "identificador" => "sec0065" "titulo" => "Greenlight laser used" ] ] ] 3 => array:2 [ "identificador" => "sec0070" "titulo" => "Multivariate model" ] ] ] 7 => array:2 [ "identificador" => "sec0075" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0080" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0085" "titulo" => "Conflict of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2011-11-06" "fechaAceptado" => "2012-03-05" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec179178" "palabras" => array:3 [ 0 => "Benign prostatic hyperplasia" 1 => "Greenlight laser" 2 => "Predictive success factors" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec179177" "palabras" => array:3 [ 0 => "Hiperplasia benigna de próstata" 1 => "Láser verde" 2 => "Factores predictivos de éxito" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To conduct a descriptive study of the implementation of greenlight laser photovaporization in a local hospital and to identify the ideal preoperative and intraoperative conditions to obtain a successful outcome.</p> <span class="elsevierStyleSectionTitle">Materials and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A retrospective review of 179 photovaporizations performed between January 2007 and June 2010 was performed. Preoperative data (age, prostate volume, PSA, IPSS, <span class="elsevierStyleItalic">Q</span><span class="elsevierStyleInf">max</span>, medical history, ASA classification), intraoperative parameters (surgeon's experience, operating time, transfusion requirements, type of laser used, reconversion to transurethral resection of the prostate or TURP) and post-operative data (post-op complications, post-op PSA, post-op IPS score, post-op <span class="elsevierStyleItalic">Q</span><span class="elsevierStyleInf">max</span> and reoperations) were analyzed.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We performed a univariate and multivariate analysis to identify which preoperative and intraoperative parameters influence therapeutic failure.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The descriptive study shows similarity in all parameters compared to the available literature. In the multivariate analysis, it was found that the surgeon's experience and prostate volume over 40<span class="elsevierStyleHsp" style=""></span>cc were independent predictive factors for success of greenlight laser photovaporization.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Greenlight laser photovaporization is an effective and reproducible procedure for treating lower urinary tract obstruction due to benign prostatic hyperplasia (BPH). Multicenter, prospective and randomized studies are needed to confirm the results of this study. There are few studies available in the literature that provide a high level of evidence and grade of recommendation.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Realizar un estudio descriptivo de la implantación de la fotovaporización con láser verde en un hospital comarcal y determinar cuáles son las condiciones preoperatorias e intraoperatorias ideales para obtener un resultado satisfactorio.</p> <span class="elsevierStyleSectionTitle">Material y métodos</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Revisión retrospectiva de 179 fotovaporizaciones realizadas entre enero de 2007 y junio de 2010, analizando datos preoperatorios (edad, volumen prostático, PSA, IPSS, Q<span class="elsevierStyleInf">máx</span>, antecedentes médicos y clasificación ASA) parámetros intraoperatorios (experiencia del cirujano, tiempo quirúrgico, requerimientos transfusionales, tipo de láser utilizado y reconversión a RTU) y postoperatorios (complicaciones, PSA, IPSS y Q<span class="elsevierStyleInf">máx</span> postoperatorios y reintervenciones).</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Realizamos estudio univariante y multivariante para identificar qué parámetros preoperatorios e intraoperatorios van a condicionar un fracaso terapéutico.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">En el estudio descriptivo se observa similitud en todos los parámetros respecto a la literatura disponible. En el estudio multivariante se identifica la experiencia del cirujano y el volumen prostático mayor de 40 cc como factores predictivos de éxito independientes para la fotovaporización con láser verde.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">La fotovaporización con láser verde es un procedimiento efectivo y reproducible en el tratamiento desobstructivo del tracto urinario inferior por hiperplasia benigna de próstata (HBP). Son necesarios estudios multicéntricos, prospectivos y aleatorizados para confirmar los resultados de este estudio. Son pocos los estudios disponibles en la literatura que aporten un nivel de evidencia y un grado de recomendación elevados.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Miralles J, et al. Análisis de factores predictivos de éxito para la fotovaporización prostática en hiperplasia benigna de próstata mediante láser verde. Actas Urol Esp. 2013;37:20–4.</p>" ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 333 "Ancho" => 1549 "Tamanyo" => 48535 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Evolution of the urinary flow. There is a statistically significant improvement between the mean preoperative <span class="elsevierStyleItalic">Q</span><span class="elsevierStyleInf">max</span> and the controls at 3, 6, 9, and 12 months after the surgery (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001).</p>" ] ] 1 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Surgical time (min) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">48.11 (45.8–50.41) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Intraoperative complications \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Reconversion 11 (6.1%)Perforation 5 (2.5%)Cardiovascular c. 1 (0.5%)Total 17 (9%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Days of stay (median) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (range<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Probing days (median) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (range<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>29) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Postoperative complications \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AUR 15 (8.3%)Incontinence (4%)Irritative syndrome 23 (12%)Hematuria 4 (2%)Urethral stenosis 1 (0.5%)Sepsis 2 (1%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Readmission \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 cases (0.02%): 2 hematuria, 2 UTI \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Postoperative <span class="elsevierStyleItalic">Q</span><span class="elsevierStyleInf">max</span> ml/s \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 months: 17 (12.26–23.09)6 months: 8.69 (15.27–22.12)9 months: 18.12 (15.73–21.40)12 months: 18.35 (15.53–21.17) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Postoperative PSA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.25 (1.34–3.16) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Postoperative IPSS (median) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (range<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>26) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Follow-up months (median) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (range<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>4–32) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab328629.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Preoperative and intraoperative data.</p>" ] ] 2 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Failure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Frequency \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Percentage \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Severe IPSS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Incontinence \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cell sclerosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Incontinence that requires sphincter \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">TUR reconversion \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">BPH remains \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Unknown \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hematuria \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab328628.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Reasons for failure.</p>" ] ] 3 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">The most important results of the variables presenting statistical significance are shown in bold.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">B</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">E.T. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Wald \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">gl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Sig. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Exp(<span class="elsevierStyleItalic">B</span>) \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Preoperative PSA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.131 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.088 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.186 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.139 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.878 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Surgical experience \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.065 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.026 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.020 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleBold">0.014</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleBold">1.067</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ultrasound volume \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.040 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.023 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.056 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.080 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.041 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab328630.png" ] ] ] ] "descripcion" => array:1 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