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Efficacy and outcome of holmium laser enucleation of prostate in patients with urinary retention due to advanced prostate cancer

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Abstract

To evaluate the efficacy and safety of holmium laser enucleation of prostate (HoLEP) for treating urinary retention in patients with advanced prostate cancer. Thirty-eight cases of advanced prostate cancer with urinary retention were enrolled in this retrospective study. All the 38 patients were treated with CAB as a basis. Among them, 21 cases chose HoLEP additionally (HoLEP group). Seventeen cases stuck to CAB alone (CAB group). Serum PSA level, International Prostate Symptom Score (IPSS), quality of life score (QoLs), maximal flow rate (Qmax), and post-void residual volume (PVR) at 3, 6, 12, and 18 months after treatment were comparatively analyzed. The perioperative and postoperative parameters of HoLEP were assessed. Both groups demonstrated significant improvement in IPSS, QoLs, Qmax, and PVR during follow-up. But these parameters of HoLEP group improved more rapidly, significantly, and durably than CAB group. No serious complications were observed during and after HoLEP. PSA level of patients in both groups declined dramatically after surgery. But PSA in HoLEP group showed more dramatic and continuous drop. Besides, 1 of 21 patients in HoLEP group transferred into castration-resistant prostate cancer (CRPC) at 18th month of follow-up. While in CAB group, 5 of 17 patients developed into CRPC at 12th month of follow-up (P = 0.02 < 0.05). HoLEP was minimally invasive, safe, and effective, and could serve as a palliative approach to rapidly restore the patients’ urine and play a cytoreductive role in advanced PCa to improve the oncological prognosis.

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Funding

This work was supported by the National Natural Science Foundation of China (grant no. 81600514).

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Authors and Affiliations

  1. Department of Urology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210000, Jiangsu, China

    Min Tang, Chengming Wang, Pu Li, Qian Zhang, Jian Qian & Xiaoxin Meng

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  1. Min Tang
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  2. Chengming Wang
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  3. Pu Li
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  4. Qian Zhang
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  5. Jian Qian
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  6. Xiaoxin Meng
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Contributions

Tang, Wang: performed the research

Li, Zhang: data collection or management

Qian: data analysis

Tang: manuscript writing/editing

Meng: project design and development

Corresponding author

Correspondence to Xiaoxin Meng.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the institutional review board of The First Affiliated Hospital of Nanjing Medical University (Nanjing, Jiangsu), and written informed consent was obtained from every participant.

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All patients gave their informed consent prior to their inclusion in the study.

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Tang, M., Wang, C., Li, P. et al. Efficacy and outcome of holmium laser enucleation of prostate in patients with urinary retention due to advanced prostate cancer. Lasers Med Sci 35, 1307–1313 (2020). https://doi.org/10.1007/s10103-019-02913-2

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  • DOI: https://doi.org/10.1007/s10103-019-02913-2

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