Impact of perioperative factors on nadir serum prostate‐specific antigen levels after holmium laser enucleation of prostate

Objective To investigate the relationship of preoperative prostate size, urinary retention, positive urine culture, and histopathological evidence of prostatitis or incidental prostate cancer on baseline and 3‐month nadir prostate‐specific antigen (PSA) value after Holmium laser enucleation of prost...

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Bibliographic Details
Published in:BJUI compass 2021-05, Vol.2 (3), p.202-210
Main Authors: Martos, Mary, Katz, Jonathan E., Parmar, Madhumita, Jain, Anika, Soodana‐Prakash, Nachiketh, Punnen, Sanoj, Gonzalgo, Mark L., Miao, Feng, Reis, Isildinha M., Smith, Nicholas, Shah, Hemendra N.
Format: Article
Language:English
Subjects:
Antigens
Biopsy
Bladder
Cancer surgery
endoscopic enucleation for prostate
Endoscopy
Generalized linear models
HoLEP
Hyperplasia
Kruskal-Wallis test
laser prostatectomy
Lasers
Medical screening
Original
Patients
Prostate cancer
prostate cancer screening
Radiation therapy
serum PSA
transurethral resection of prostate
Tumors
Ultrasonic imaging
Urinary retention
Urine
Urological surgery
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Summary:Objective To investigate the relationship of preoperative prostate size, urinary retention, positive urine culture, and histopathological evidence of prostatitis or incidental prostate cancer on baseline and 3‐month nadir prostate‐specific antigen (PSA) value after Holmium laser enucleation of prostate (HoLEP). Patients and methods Data from 90 patients who underwent a HoLEP by En‐bloc technique were analyzed. PSA values at baseline and at 3‐month follow‐up, preoperative urinary retention and urine culture status, weight of resected tissue, and histopathological evidence of prostatitis or prostate cancer were recorded. We performed univariable and multivariable gamma‐regression analyses to determine the impact of the aforementioned perioperative variables on preoperative PSA, 3‐month postoperative PSA, and change in PSA. Results Serum PSA reduced significantly at 3 months from 6.3 ± 5.9 ng/mL to 0.6 ± 0.6 ng/mL. On both univariable and multivariable analysis, 3‐month nadir level was independent of all preoperative factors examined, except preoperative urinary retention status. Although patients with smaller prostate (resected tissue weight 80 g) (77.67% vs 89.06%; P 
ISSN:2688-4526
2688-4526
DOI:10.1002/bco2.68