Preoperative use of 5α-reductase inhibitors (5ARIs) may cause fibrosis of the prostate tissue and reduce the efficiency of thulium laser surgery for treating benign prostate hyperplasia (BPH). Thus, we investigated the effects of preoperative 5ARI use in this setting.
This retrospective study examined 184 patients who underwent thulium laser surgery for BPH during 2012-2017. Patients were grouped according to their 5ARI use in order to compare their preoperative and intraoperative characteristics and subsequent outcomes. Surgical efficiency was assessed using vaporesection efficiency. The total operation time, vaporesection time and prostate volume change were measured.
The 5ARI+ group included 83 patients (45.1%) and the 5ARI- group included 101 patients (54.9%). There were no significant differences in the two groups' preoperative characteristics, postoperative prostate size, thulium laser energy use, or prostate volume reduction rate. However, relative to the 5ARI- group, the 5ARI+ group had a significant shorter total operative time (65.0 min vs. 70.0 min, p=0.013) and a significantly shorter vaporesection time (48.0 min vs. 54.0 min, p=0.014), which resulted in significantly higher vaporesection efficiency in the 5ARI+ group (0.66 mL/min vs. 0.51 mL/min, p<0.001). Both groups exhibit significant improvements in their quality of life score and International Prostate Symptom Score during the 12-month follow-up.
In contrast with our expectations, the preoperative use of 5ARI increased the efficiency of thulium laser surgery for BPH. Thus, it may not be necessary to stop 5ARI treatment before performing thulium laser surgery in this setting.
Investigative and clinical urology. 2019 Dec 17 [Epub]
Jae Seung Chung, Won Ik Seo, Cheol Kyu Oh, Seong Cheol Kim, Myung Chan Park, Sang Hyun Park, Jihyeong Yu, Chan Ho Lee, Wansuk Kim, Tae Yong Park, Kweon Sik Min, Jae Il Chung
Department of Urology, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea., Department of Urology, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea., Department of Urology, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.