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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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| Published in: | BJUI compass 2021-05, Vol.2 (3), p.202-210 |
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| creator | 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. |
| description | 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 |
| doi_str_mv | 10.1002/bco2.68 |
| format | article |
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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 <40 g) had less percentile reduction in PSA when compared with those with larger prostate (resected tissue weight >80 g) (77.67% vs 89.06%; P < .001), patients from both these groups noted a similar PSA nadir level after 3 months (0.54 vs 0.56 ng/dL). The drop in PSA level after HoLEP remained stable up to 1‐year follow‐up.
Conclusions
PSA nadir 3 months after HoLEP remains relatively consistent across patients, regardless of preoperative prostate size, PSA value, urine culture status, and histopathological evidence of prostatitis or incidental prostate cancer.</description><identifier>ISSN: 2688-4526</identifier><identifier>EISSN: 2688-4526</identifier><identifier>DOI: 10.1002/bco2.68</identifier><identifier>PMID: 35475131</identifier><language>eng</language><publisher>United States: John Wiley & Sons, Inc</publisher><subject>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</subject><ispartof>BJUI compass, 2021-05, Vol.2 (3), p.202-210</ispartof><rights>2021 The Authors. published by John Wiley & Sons Ltd on behalf of BJU International Company</rights><rights>2021 The Authors. BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company.</rights><rights>2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4668-afd416ccc8ec172dcd19eb09c14ff842badf38363b36973a70ddca25174da04d3</citedby><cites>FETCH-LOGICAL-c4668-afd416ccc8ec172dcd19eb09c14ff842badf38363b36973a70ddca25174da04d3</cites><orcidid>0000-0002-4273-5502 ; 0000-0001-8175-790X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2890705575/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2890705575?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,11562,25753,27924,27925,37012,44590,46052,46476,53791,53793,75126</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35475131$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Martos, Mary</creatorcontrib><creatorcontrib>Katz, Jonathan E.</creatorcontrib><creatorcontrib>Parmar, Madhumita</creatorcontrib><creatorcontrib>Jain, Anika</creatorcontrib><creatorcontrib>Soodana‐Prakash, Nachiketh</creatorcontrib><creatorcontrib>Punnen, Sanoj</creatorcontrib><creatorcontrib>Gonzalgo, Mark L.</creatorcontrib><creatorcontrib>Miao, Feng</creatorcontrib><creatorcontrib>Reis, Isildinha M.</creatorcontrib><creatorcontrib>Smith, Nicholas</creatorcontrib><creatorcontrib>Shah, Hemendra N.</creatorcontrib><title>Impact of perioperative factors on nadir serum prostate‐specific antigen levels after holmium laser enucleation of prostate</title><title>BJUI compass</title><addtitle>BJUI Compass</addtitle><description>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 <40 g) had less percentile reduction in PSA when compared with those with larger prostate (resected tissue weight >80 g) (77.67% vs 89.06%; P < .001), patients from both these groups noted a similar PSA nadir level after 3 months (0.54 vs 0.56 ng/dL). The drop in PSA level after HoLEP remained stable up to 1‐year follow‐up.
Conclusions
PSA nadir 3 months after HoLEP remains relatively consistent across patients, regardless of preoperative prostate size, PSA value, urine culture status, and histopathological evidence of prostatitis or incidental prostate cancer.</description><subject>Antigens</subject><subject>Biopsy</subject><subject>Bladder</subject><subject>Cancer surgery</subject><subject>endoscopic enucleation for prostate</subject><subject>Endoscopy</subject><subject>Generalized linear models</subject><subject>HoLEP</subject><subject>Hyperplasia</subject><subject>Kruskal-Wallis test</subject><subject>laser prostatectomy</subject><subject>Lasers</subject><subject>Medical screening</subject><subject>Original</subject><subject>Patients</subject><subject>Prostate cancer</subject><subject>prostate cancer screening</subject><subject>Radiation therapy</subject><subject>serum PSA</subject><subject>transurethral resection of prostate</subject><subject>Tumors</subject><subject>Ultrasonic imaging</subject><subject>Urinary retention</subject><subject>Urine</subject><subject>Urological surgery</subject><issn>2688-4526</issn><issn>2688-4526</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNp1kk9rFDEUwAdRbGmL30ACHjyUbfNvksxF0KXqQqEXPYdM8rLNMjMZk5mVHgp-BD9jP4lZdy3twUsSXn75vZe8VNUbgi8IxvSytZFeCPWiOqZCqQWvqXj5ZH1UneW8wYVkhEmGX1dHrOayJowcV_erfjR2QtGjEVKIZTBT2ALyJRpTRnFAg3EhoQxp7tGYYp7MBA-_fucRbPDBIjNMYQ0D6mALXUbGT5DQbez6UA50phxEMMy2g2Iuul2qg-W0euVNl-HsMJ9U3z9ffVt-XVzffFktP14vLBdCLYx3nAhrrQJLJHXWkQZa3FjCvVectsZ5pphgLRONZEZi56yhNZHcGcwdO6lWe6-LZqPHFHqT7nQ0Qf8NxLTWJk2hlKhp7QzlwgmKJaeYtpgCb1XTNr4RQvLi-rB3jXPbg7MwTMl0z6TPd4Zwq9dxq1WjlGBNEbw7CFL8MUOe9CbOaSj311Q1WOK6lnWh3u8pW94qJ_CPGQjWu7brXdu1UIV8-7SgR-5fkwtwvgd-hg7u_ufRn5Y35c-wP-Lgues</recordid><startdate>202105</startdate><enddate>202105</enddate><creator>Martos, Mary</creator><creator>Katz, Jonathan E.</creator><creator>Parmar, Madhumita</creator><creator>Jain, Anika</creator><creator>Soodana‐Prakash, Nachiketh</creator><creator>Punnen, Sanoj</creator><creator>Gonzalgo, Mark L.</creator><creator>Miao, Feng</creator><creator>Reis, Isildinha M.</creator><creator>Smith, Nicholas</creator><creator>Shah, Hemendra N.</creator><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><general>Wiley</general><scope>24P</scope><scope>WIN</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-4273-5502</orcidid><orcidid>https://orcid.org/0000-0001-8175-790X</orcidid></search><sort><creationdate>202105</creationdate><title>Impact of perioperative factors on nadir serum prostate‐specific antigen levels after holmium laser enucleation of prostate</title><author>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.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4668-afd416ccc8ec172dcd19eb09c14ff842badf38363b36973a70ddca25174da04d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Antigens</topic><topic>Biopsy</topic><topic>Bladder</topic><topic>Cancer surgery</topic><topic>endoscopic enucleation for prostate</topic><topic>Endoscopy</topic><topic>Generalized linear models</topic><topic>HoLEP</topic><topic>Hyperplasia</topic><topic>Kruskal-Wallis test</topic><topic>laser prostatectomy</topic><topic>Lasers</topic><topic>Medical screening</topic><topic>Original</topic><topic>Patients</topic><topic>Prostate cancer</topic><topic>prostate cancer screening</topic><topic>Radiation therapy</topic><topic>serum PSA</topic><topic>transurethral resection of prostate</topic><topic>Tumors</topic><topic>Ultrasonic imaging</topic><topic>Urinary retention</topic><topic>Urine</topic><topic>Urological surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Martos, Mary</creatorcontrib><creatorcontrib>Katz, Jonathan E.</creatorcontrib><creatorcontrib>Parmar, Madhumita</creatorcontrib><creatorcontrib>Jain, Anika</creatorcontrib><creatorcontrib>Soodana‐Prakash, Nachiketh</creatorcontrib><creatorcontrib>Punnen, Sanoj</creatorcontrib><creatorcontrib>Gonzalgo, Mark L.</creatorcontrib><creatorcontrib>Miao, Feng</creatorcontrib><creatorcontrib>Reis, Isildinha M.</creatorcontrib><creatorcontrib>Smith, Nicholas</creatorcontrib><creatorcontrib>Shah, Hemendra N.</creatorcontrib><collection>Wiley Open Access</collection><collection>Wiley-Blackwell Free Backfiles(OpenAccess)</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>BJUI compass</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Martos, Mary</au><au>Katz, Jonathan E.</au><au>Parmar, Madhumita</au><au>Jain, Anika</au><au>Soodana‐Prakash, Nachiketh</au><au>Punnen, Sanoj</au><au>Gonzalgo, Mark L.</au><au>Miao, Feng</au><au>Reis, Isildinha M.</au><au>Smith, Nicholas</au><au>Shah, Hemendra N.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of perioperative factors on nadir serum prostate‐specific antigen levels after holmium laser enucleation of prostate</atitle><jtitle>BJUI compass</jtitle><addtitle>BJUI Compass</addtitle><date>2021-05</date><risdate>2021</risdate><volume>2</volume><issue>3</issue><spage>202</spage><epage>210</epage><pages>202-210</pages><issn>2688-4526</issn><eissn>2688-4526</eissn><abstract>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 <40 g) had less percentile reduction in PSA when compared with those with larger prostate (resected tissue weight >80 g) (77.67% vs 89.06%; P < .001), patients from both these groups noted a similar PSA nadir level after 3 months (0.54 vs 0.56 ng/dL). The drop in PSA level after HoLEP remained stable up to 1‐year follow‐up.
Conclusions
PSA nadir 3 months after HoLEP remains relatively consistent across patients, regardless of preoperative prostate size, PSA value, urine culture status, and histopathological evidence of prostatitis or incidental prostate cancer.</abstract><cop>United States</cop><pub>John Wiley & Sons, Inc</pub><pmid>35475131</pmid><doi>10.1002/bco2.68</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-4273-5502</orcidid><orcidid>https://orcid.org/0000-0001-8175-790X</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | BJUI compass, 2021-05, Vol.2 (3), p.202-210 |
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| language | eng |
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| source | Publicly Available Content Database; PubMed Central(OpenAccess); Wiley Open Access |
| 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 |
| title | Impact of perioperative factors on nadir serum prostate‐specific antigen levels after holmium laser enucleation of prostate |
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