This study was aimed to compare serial long-term postoperative changes in quality-of-life (QoL) between photoselective-vaporization (PVP) using 120W-High-Performance-System and holmium-laser-enucleation (HoLEP) in benign-prostatic-hyperplasia (BPH) patients and to identify factors influencing the QoL improvement at the short-term, mid-term and long-term follow-up visits after surgery. We analyzed 1,193 patients with a baseline QoL-index ≥2 who underwent PVP (n = 439) or HoLEP (n = 754). Surgical outcomes were serially compared between the two groups at up to 60-months using the International-Prostatic-Symptom-Score (I-PSS), uroflowmetry, and serum PSA. We used logistic regression analysis to identify predictors of QoL improvement (a reduction in the QoL-index ≥50% compared with baseline) at the short-term (12-months), mid-term (36-months), and long term (60-months) follow-up after surgery. In both groups, the QoL-index was decreased throughout the entire follow-up period compared with that at baseline. There were no significant differences in postoperative changes from the baseline QoL-index between the two groups during the 48-month follow-up, except at 60-months. The degree of improvement in QoL at 60-months after HoLEP was greater than that after PVP. A lower baseline storage-symptom-subscore and a higher bladder-outlet-obstruction-index (BOOI) were independent factors influencing QoL improvement at the short-term. No independent factor influences QoL improvement at the mid- or long-term.
Scientific reports. 2019 Jun 04*** epublish ***
Inyoung Sun, Sangjun Yoo, Juhyun Park, Sung Yong Cho, Hyeon Jeong, Hwancheol Son, Seung-June Oh, Jae-Seung Paick, Min Chul Cho
Department of Urology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, 03080, Republic of Korea., Department of Urology, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul, 07061, Republic of Korea., Department of Urology, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul, 07061, Republic of Korea. .