Changing patients’ profile presenting for surgical management of benign prostatic hyperplasia over the past 16 years: A single-centre perspective

Authors

  • Mohamed A Elkoushy McGill University Health Center, Montreal QC, Canada Suez Canal University, Ismailia, Egypt
  • Ahmed M Elshal McGill University Health Center, Montreal QC, Canada Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
  • Mostafa M Elhilali McGill University Health Centre, Montreal QC, Canada

DOI:

https://doi.org/10.5489/cuaj.3066

Abstract

Introduction: We assessed the change of patients’ profile presenting for symptomatic benign prostatic hyperplasia (BPH) over 16 years and its impact on surgical outcomes over this time.

Methods: We reviewed a prospectively maintained database of patients treated with laser for symptomatic BPH since March 1998. Patients were divided into 3 consecutive time-based groups: Group 1 for patients who underwent surgery before April 2004; Group 2, between April 2004 and March 2009; and for Group 3 from April 2009 to August 2014. We reviewed demographic and preoperative data, including prostate volume; international prostate symptoms score (IPSS), quality of life (QoL), and peak flow rate (Qmax). We also recorded any perioperative and long-term complications.

Results: A total of 1835 patients were included in our study, including 542 (29.5%) in Group 1, 614 (33.5%) in Group 2, and 679 (37%) in Group 3. Preoperative prostate volume was positively correlated with age at surgery (r = 0.62, p < 0.001), total energy used (r = 0.47, p < 0.001), and total operative time (r = 0.47, p < 0.001). Patients in Group 3 were significantly older (75.28 ± 8.47 in Group 3 vs. 71.11 ± 8.9 in Group 2 vs. 65.3 ± 9.04 years in Group 1, p 72 years), prostate volume (>80 cc), operative time (>95 minutes), and preoperative PSA (>6 ng/dL) were significantly associated with postoperative urinary incontinence.

Conclusions: Patients presenting for surgery due to symptomatic BPH over the last 16 years were significantly older, more morbid, and had larger prostates and more abnormal voiding parameters. Over time, patients used prostatic medications more frequently. Despite the changes in patient profiles, perioperative safety and complication rates between groups were comparable, likely due to advancements in laser technology and techniques. Age (>72 years), prostate volume (>80 cc), operative time (>95 minutes), and preoperative PSA (>6 ng/dL) were significantly associated with reversible postoperative urinary incontinence.

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Author Biography

Mostafa M Elhilali, McGill University Health Centre, Montreal QC, Canada

Professor of Urology

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Published

2015-12-14

How to Cite

Elkoushy, M. A., Elshal, A. M., & Elhilali, M. M. (2015). Changing patients’ profile presenting for surgical management of benign prostatic hyperplasia over the past 16 years: A single-centre perspective. Canadian Urological Association Journal, 9(11-12), 372–8. https://doi.org/10.5489/cuaj.3066

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Section

Original Research