Wie gut sind wir wirklich? Interventionsbedürftige Nachblutungen und intraoperative Elektrokoagulationen bei der Thulium-Laser-Enukleation der Prostata

Zusammenfassung

Die interventionsbedürftige Nachblutung stellt eine wichtige Komplikation bei der Thulium-Laser-Enukleation der Prostata (ThuLEP) dar. Ziel dieser Untersuchung war diese Komplikation bei der Behandlung einer benignen Prostatavergrößerung retrospektiv zu analysieren. Die Arbeit konzentriert sich auf die Untersuchung möglicher ursächlicher Faktoren für interventionsbedürftige Nachblutungen sowie die Anwendung einer intraoperativen Elektrokoagulation. Insgesamt wurden 503 ThuLEPs im Zeitraum von 08/2021–07/2022 untersucht.

Bei 4,2% (n=21) der Patienten trat postoperativ eine interventionsbedürftige Nachblutung auf. Die Daten konnten zeigen, dass bei diesen Nachblutungen eine signifikante Assoziation zwischen einem hohem Prostatavolumen, einem hohem Enukleationsgewicht sowie einer intraoperativen Elektrokoagulation bestand. Bei insgesamt 41,2% (n=207) der Fälle wurde intraoperativ eine Elektrokoagulation angewandt. In diesen Fällen bedingte statistisch signifikant eine intraoperative Kapselperforation sowie eine hohes Enukleationsgewicht die Anwendung einer Elektrokoagulation.

Abstract

The need for intervention due to postoperative bleeding represents a significant complication in Thulium Laser Enucleation of the Prostate (ThuLEP). This study aimed to retrospectively analyse this complication in the treatment of benign prostatic enlargement. This study focuses on investigating potential causative factors for postoperative bleeding requiring intervention as well as the use of intraoperative electrocoagulation. A total of 503 ThuLEP procedures performed between 08/2021 and 07/2022 were examined.

Postoperatively, 4.2% (n=21) of patients experienced bleeding requiring intervention. Study data revealed a significant association between these instances of bleeding and a high prostate volume (p=0.004), high enucleation weight (p=0.004), and intraoperative electrocoagulation (p=0.048). In total, intraoperative electrocoagulation was applied in 41.2% (n=207) of cases. In these cases, statistically significant factors leading to the application of electrocoagulation included intraoperative capsule perforation (p=0.005) and high enucleation weight (p=0.002).

Schlüsselwörter

Benigne Prostatahyperplasie - Thulium-Laser-Enukleation - Prostata - Komplikationen - Endourologie

Keywords

benign prostatic hyperplasia - thulium laser enucleation - prostate - complications

Publication History

Received: 13 January 2024

Accepted after revision: 11 March 2024

Article published online:
17 April 2024

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