MP32-17 ENERGY IMPACT ON STORAGE SYMPTOMS AFTER THULIUM ENUCLEATION OF PROSTATE: A LARGE MULTI INSTITUTIONAL ANALYSIS

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology II (MP32)1 Apr 2020MP32-17 ENERGY IMPACT ON STORAGE SYMPTOMS AFTER THULIUM ENUCLEATION OF PROSTATE: A LARGE MULTI INSTITUTIONAL ANALYSIS Sebastiano Nazzani*, Oskar Blezien, Gloria Motta, Filippo Molinari, Claudia Signorini, Dario Ratti, Pietro Acquati, Robert Stubinski, Stefano Picozzi, and Luca Carmignani Sebastiano Nazzani*Sebastiano Nazzani* More articles by this author , Oskar BlezienOskar Blezien More articles by this author , Gloria MottaGloria Motta More articles by this author , Filippo MolinariFilippo Molinari More articles by this author , Claudia SignoriniClaudia Signorini More articles by this author , Dario RattiDario Ratti More articles by this author , Pietro AcquatiPietro Acquati More articles by this author , Robert StubinskiRobert Stubinski More articles by this author , Stefano PicozziStefano Picozzi More articles by this author , and Luca CarmignaniLuca Carmignani More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000876.017AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Impact of energy delivery during enucleation of prostate on storage symptoms is still unknown. We aimed to test how energy delivery influences postoperative storage symptoms in a large cohort of benign prostatic obstruction patients who underwent Thulium enucleation of prostate (ThuVep). METHODS: Within our multi-institutional database with prospective collected data we selected patients treated with ThuVep (Quanta System Cyber TM 200 W). Preoperative, 7 days and 30 days International Prostatic Symptoms Score (IPSS) questionnaires were administered. Storage symptoms were considered as frequency, urgency and nocturia according to IPSS questionnaire. Energy administered during the procedure was recorded and its ratio with trans rectal ultrasound prostate size was calculated. Finally, patients were stratified according to median energy delivered per gram of prostate. The statistical significance of differences in medians and proportions was tested with the Kruskal-Wallis and chi-square tests. RESULTS: Between 2014 and 2018, we identified 228 patients treated with ThuVep. Median prostate volume was 70 [Interquartile Range: (IQR) 50-104 grams] and median energy delivered per gram was 3207 Joule (IQR: 1904 - 4956 Joule). Median operative time was 86 minutes. Low energy (<3207 Joule) patients were less frequently in antiplatelet (10.5% vs 26%; p=0.01) and anticoagulant therapy (2.6% vs 7.9%; p=0.01). Preoperative urgency (1.5 vs 1.5; p= 1), frequency (1.7 vs 1.9; p=0.7) and nocturia (2.3 vs 2.5; p=0.3) were similar in the two cohorts. Similarly, no differences were found in term of preoperative indwelling catheter. Hemoglobin drop (-0.9 vs -0.7 grams/dL; p =0.03) and catheterization time were lower ( 37 vs 30; p =0.05) in high energy patients. 7 and 30 days urgency and frequency were comparable in the two cohorts. Finally, 7 days nocturia was higher (1.8 vs 2.3; p=0.1) in high energy patients, albeit in a non significant fashion. CONCLUSIONS: Based on our results no statistically significant difference exist in term of overall storage symptoms according to energy per gram delivered. Conversely, 7 days nocturia appears to be more frequent in high-energy patients. However, no statistically significant difference was found. Finally, high-energy patients had lower catheterization time and hemoglobin drop. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e491-e491 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sebastiano Nazzani* More articles by this author Oskar Blezien More articles by this author Gloria Motta More articles by this author Filippo Molinari More articles by this author Claudia Signorini More articles by this author Dario Ratti More articles by this author Pietro Acquati More articles by this author Robert Stubinski More articles by this author Stefano Picozzi More articles by this author Luca Carmignani More articles by this author Expand All Advertisement PDF downloadLoading ...