Concomitant Prostate Needle Biopsy and Laser Vaporization of the Prostate Could Be a Risk of Postoperative Hemoglobin Decline, a Retrospective Study

Figures & data

Table 1 Patient Characteristics

	All patients (n = 106)	CVP + biopsy (n = 16)	CVP (n = 90)	P-value
Age, yr (IQR)	73 (66–80)	80 (75–84)	71 (66–79)	0.001
Body mass index, kg/m^2 (IQR)	23.8 (21.3–25.8)	22.4 (21.0–25.8)	24.0 (21.5–25.7)	0.694
Prostate volume, mL (IQR)	50 (35–75)	67 (48–85)	45 (31–70)	0.014
PSA level, ng/mL (IQR)	4.17 (1.59–6.19)	6.67 (5.42–10.95)	3.68 (1.49–5.68)	0.468
PSA density, ng/mL/mL (IQR)	0.07 (0.04–0.12)	0.11 (0.07–0.17)	0.07 (0.03–0.12)	0.948
Preoperative hemoglobin level, g/dL (IQR)	13.7 (13.0–14.7)	13.4 (13.0–14.6)	13.8 (13.0–14.7)	0.854
Continuance of antithrombotic therapy, n (%)	16 (15.1)	2 (12.5)	14 (15.6)	1.000
Preoperative postvoid residual urine volume, cc (IQR)	98 (50–226)	247 (68–700)	90 (46–166)	0.158
History of urinary retention, n (%)	46 (43.4)	7 (43.8)	39 (43.3)	0.975
Preoperative usage of urethral catheter, n (%)	25 (23.6)	5 (31.2)	20 (22.2)	0.523
History of prostate biopsy, n (%)	39 (36.8)	2 (12.5)	37 (41.1)	0.046
Operative time, min (IQR)	41 (27–56)	43 (35–63)	39 (27–56)	0.464
Laser treatment time, sec (IQR)	1237 (898–1852)	1285 (1051–1788)	1198 (849–1933)	0.902
Total laser energy, kJ (IQR)	138 (84–243)	171 (116–248)	131 (81–239)	0.760
Operative use of transurethral bipolar coagulation, n (%)	14 (13.2)	3 (18.8)	11 (12.2)	0.082
Hemoglobin level at postoperative day one, g/dL (IQR)	13.5 (12.5–14.2)	13.1 (12.0–13.9)	13.8 (12.7–14.3)	0.112
Rate of hemoglobin decline at postoperative day one, (IQR)	0.02 (0.00–0.05)	0.05 (−0.01–0.09)	0.02 (0.00–0.05)	0.023
Perioperative blood transfusion, n (%)	0 (0)	0 (0)	0 (0)	0.440
Length of postoperative urethral catheterization, day (IQR)	3 (3–4)	4 (3–5)	3 (3–4)	0.024
Length of hospitalization, day (IQR)	6 (6–7)	6 (6–7)	6 (6–7)	0.895
Postvoid residual urine volume at three months after the operation, cc (IQR)	46 (27–89)	56 (25–181)	46 (26–84)	0.198
Positive for cancer, n (%)	2 (1.9)	2 (12.5)	−

Abbreviations: CVP, contact laser vaporization of the prostate; IQR, interquartile range; PSA, prostate-specific antigen.

Table 2 Complications after Surgery

	All patients (n = 106)	CVP + biopsy (n = 16)	CVP (n = 90)	P-value
All grades, n (%)	40 (37.7)	5 (31.2)	35 (38.9)	0.470
Hematuria, n (%)	14 (13.2)	2 (12.5)	12 (13.3)	0.627
Urinary retention, n (%)	13 (12.2)	0 (0)	13 (14.4)	0.120
Urinary tract infection, n (%)	6 (5.7)	2 (12.5)	4 (4.4)	0.200
Urinary tract obstruction, n (%)	4 (3.8)	1 (6.3)	3 (3.3)	0.462
Stress urinary incontinence, n (%)	2 (1.9)	0 (0)	2 (2.2)	0.736
Aspiration, n (%)	1 (0.9)	0 (0)	1 (1.1)	0.858
Grade 3 or above, n (%)	11 (10.4)	2 (12.5)	9 (10.0)	0.483
Hematuria, n (%)	6 (5.7)	2 (12.5)	4 (4.4)	0.200
Urinary tract obstruction, n (%)	3 (2.8)	0 (0)	3 (3.3)	0.630
Urinary tract infection, n (%)	1 (0.9)	0 (0)	1 (1.1)	0.858
Aspiration, n (%)	1 (0.9)	0 (0)	1 (1.1)	0.858

Abbreviation: CVP, contact laser vaporization of the prostate.

Table 3 Multivariate Analysis for Factors Associated with Hemoglobin Decline of More Than 5% on Postoperative Day One

	Hemoglobin decline		Univariate	Multivariate
	≤5% (n = 86)	>5% (n = 20)	p-value	p-value	Odds ratio (95% CI)
Concomitant biopsy, n (%)	9 (10.5)	7 (35.0)	0.006	0.009	4.61 (1.46–14.5)
Age > 73 years, n (%)	47 (54.7)	6 (30.0)	0.047
Body mass index > 23.7 kg/m^2, n (%)	43 (50.0)	10 (50.0)	1.000
Prostate volume > 50 mL, n (%)	38 (44.2)	12 (60.0)	0.638
PSA level > 4.17 ng/mL, n (%)	40 (46.5)	15 (75.0)	0.019
PSA density > 0.07 ng/mL/mL, n (%)	41 (47.7)	11 (55.0)	0.555
Preoperative hemoglobin level > 13.7 g/dL, n (%)	36 (41.9)	15 (75.0)	0.012
Continuation of antithrombotic therapy, n (%)	13 (15.1)	3 (15.0)	0.647
Operative time > 41 min, n (%)	41 (47.7)	10 (50.0)	0.851
Laser treatment time > 1237 sec, n (%)	39 (45.3)	13 (65.0)	0.255
Total laser energy > 138 kJ, n (%)	41 (47.7)	12 (60.0)	0.321

Abbreviations: CI, confidence interval; IQR, interquartile range; PSA, prostate-specific antigen.