A novel outcomes categorization for current minimally invasive ejaculation-sparing treatments of benign prostatic hyperplasia: Results of a multicentric series

You have accessJournal of UrologyCME1 Apr 2023PD41-07 A NOVEL OUTCOMES CATEGORIZATION FOR CURRENT MINIMALLY INVASIVE EJACULATION-SPARING TREATMENTS OF BENIGN PROSTATIC HYPERPLASIA: RESULTS OF A MULTICENTRIC SERIES Umberto Anceschi, Daniele Amparore, Giampaolo Siena, Andrea Cocci, Enrico Checcucci, Francesco Prata, Sabrina De Cillis, Rocco Simone Flammia, Antonio Tufano, Alberto Quarà, Michele Ortenzi, Aldo Brassetti, Alfredo Maria Bove, Gabriele Tuderti, Simone D'Annunzio, Lorenzo Viola, Francesco Sessa, Pietro Spatafora, Cristian Fiori, Francesco Varvello, Andrea Minervini, Giuseppe Ferrari, Francesco Porpiglia, Luca Cindolo, and Giuseppe Simone Umberto AnceschiUmberto Anceschi More articles by this author , Daniele AmparoreDaniele Amparore More articles by this author , Giampaolo SienaGiampaolo Siena More articles by this author , Andrea CocciAndrea Cocci More articles by this author , Enrico CheccucciEnrico Checcucci More articles by this author , Francesco PrataFrancesco Prata More articles by this author , Sabrina De CillisSabrina De Cillis More articles by this author , Rocco Simone FlammiaRocco Simone Flammia More articles by this author , Antonio TufanoAntonio Tufano More articles by this author , Alberto QuaràAlberto Quarà More articles by this author , Michele OrtenziMichele Ortenzi More articles by this author , Aldo BrassettiAldo Brassetti More articles by this author , Alfredo Maria BoveAlfredo Maria Bove More articles by this author , Gabriele TudertiGabriele Tuderti More articles by this author , Simone D'AnnunzioSimone D'Annunzio More articles by this author , Lorenzo ViolaLorenzo Viola More articles by this author , Francesco SessaFrancesco Sessa More articles by this author , Pietro SpataforaPietro Spatafora More articles by this author , Cristian FioriCristian Fiori More articles by this author , Francesco VarvelloFrancesco Varvello More articles by this author , Andrea MinerviniAndrea Minervini More articles by this author , Giuseppe FerrariGiuseppe Ferrari More articles by this author , Francesco PorpigliaFrancesco Porpiglia More articles by this author , Luca CindoloLuca Cindolo More articles by this author , and Giuseppe SimoneGiuseppe Simone More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003346.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We proposed a novel scoring system that summarizes composite outcomes for benign prostate hyperplasia (BPH) treatment and we sought to identify its predictors on a large multicentric dataset of minimally-invasive techniques. METHODS: Seven datasets were merged and queried for “urethral-sparing robotic simple prostatectomy” (usRASP; n=94; Group A), “waterjet ablation” (WA; n=95; Group B) and “Rezum” (n=308; Group C). Patients with a follow-up <12 months (n=32) or missing data (n=28) were excluded. “Complete clinical success” (CS) was defined as the coexistence of: 1) Reduction of ≥30% in International Prostatic Symptoms Score (IPSS) at 12 months compared to baseline; 2) Response to MSHQ-EjD-3 indicating ejaculation within 12 months during follow-up; 3) No perioperative complications ≥III on the Clavien-Dindo classification. Simultaneous achievement of only two of the presented criteria was considered a “partial clinical” success (PS). A logistic binary regression model was built to identify predictors of CS. RESULTS: The median follow-up of the overall cohort was 39.8 months (IQR 27.1-46.8). In the A group a complete, partial, absent clinical success was observed in 66%, 28.7%, 5.3% of cases, respectively (Table 1). In the B group the complete clinical, partial and absent rates were 73.6%, 14.7%, 3.5% while in the C group were 68.8%, 20.1%, 11%, respectively (Table 1). No significant difference was found between groups for any of the CS endpoint considered (30% IPSS reduction; p=0.455, ejaculation rates; p=0.07, perioperative complications rates; p=0.445; Table 1). On multivariable logistic regression analysis, prostate volume <110 mL (OR 0.52; 95% CI 0.29-0.95; p=0.034), higher preoperative SHIM score (OR 1.07; 95% CI 1.03-1.11; p<0.001) and reduced catheterization time (OR 0.91; 95% CI 0.86-0.96; p=0.02) were independent predictors of complete clinical success. CONCLUSIONS: We suggested a novel, comprehensive metric to assess 1-year composite outcomes, safety, and efficacy for any of minimally-invasive treatments for BPH. Irrespectively of the surgical technique considered, a preoperative prostate volume <110 ml and unimpaired sexual function are necessary conditions for expecting a complete clinical success. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1061 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Umberto Anceschi More articles by this author Daniele Amparore More articles by this author Giampaolo Siena More articles by this author Andrea Cocci More articles by this author Enrico Checcucci More articles by this author Francesco Prata More articles by this author Sabrina De Cillis More articles by this author Rocco Simone Flammia More articles by this author Antonio Tufano More articles by this author Alberto Quarà More articles by this author Michele Ortenzi More articles by this author Aldo Brassetti More articles by this author Alfredo Maria Bove More articles by this author Gabriele Tuderti More articles by this author Simone D'Annunzio More articles by this author Lorenzo Viola More articles by this author Francesco Sessa More articles by this author Pietro Spatafora More articles by this author Cristian Fiori More articles by this author Francesco Varvello More articles by this author Andrea Minervini More articles by this author Giuseppe Ferrari More articles by this author Francesco Porpiglia More articles by this author Luca Cindolo More articles by this author Giuseppe Simone More articles by this author Expand All Advertisement PDF downloadLoading ...