The main objective of this multicentric retrospective pilot study was to evaluate the one-year follow-up safety (i.e. minor (Clavien-Dindo I-II) and major (Clavien-Dindo ≥III) complications) of holmium enucleation of the prostate (HoLEP), GreenLight photo selective vaporization of the prostate (GL PVP) and TURP performed after KT. The secondary objectives were to evaluate the efficacy and to assess the impact of these procedures on graft function.
We retrospectively included all KT recipients who underwent a HoLEP or GL PVP or TURP for benign prostatic hyperplasia (BPH) in three French university centers.
From January 2013 to April 2018, 60 BPH endoscopic surgical procedures in KT recipients were performed: 17 HoLEP (HoLEP group), 9 GL PVP (GL PVP group) and 34 TURP (TURP group). Age, BMI, preoperative serum creatinine, preoperative IPSS, preoperative Qmax, preoperative PSA, medical history of AUR, UTI and indwelling urethral catheter were similar in all study groups. Mean preoperative prostate volume was higher in HoLEP group. The rate of overall post-operative complications was statistically higher in the HoLEP group (11/17 (64.7%) versus 1/9 (11.1%) versus 12/34 (35.3%) in HoLEP group, GL PVP group and TURP group, respectively, p=0.02), with higher rate of long term UTI and AUR. Qmax improved in all groups after surgery. Delta POM 12 – preoperative serum creatinine was similar in the all groups.
Although our study is underpowered, the rate of post-operative complications is higher with HoLEP procedure, in comparison with GL PVP, for the treatment of BPH after KT. One-year efficacy is similar in HoLEP, GL PVP and TURP groups. Further prospective randomized controlled trials are needed to confirm our results.
Journal of endourology. 2019 Oct 05 [Epub ahead of print]
Thomas Prudhomme, Thibault Marquette, Morgane Péré, Pierre Marie Patard, Clément Michiels, Federico Sallusto, Jerome Rigaud, Pascal Glémain, Nassim Kamar, Gilles Blancho, Michel Soulie, Pascal Rischmann, Georges Karam, Xavier Gamé, Gregoire Robert, Julien Branchereau
CHU Toulouse, 36760, Department of Urology, Kidney Transplantation and Andrology, Toulouse, France; ., Centre Hospitalier Universitaire de Bordeaux Groupe hospitalier Pellegrin, 158435, Urology, Bordeaux, Aquitaine, France; ., CHU Nantes, 26922, Biostatistics Unit, Research Board, Nantes, France; ., CHU Toulouse, 36760, Department of Urology, Kidney Transplantation and Andrology, Toulouse, France; ., Centre Hospitalier Universitaire de Bordeaux Groupe hospitalier Pellegrin, 158435, Urology, Bordeaux, Aquitaine, France; ., CHU Toulouse, 36760, Department of Urology, Kidney Transplantation and Andrology, Toulouse, France; ., CHU Nantes, 26922, Institut de Transplantation Urologie Néphrologie (ITUN), Nantes, Pays de la Loire, France; ., CHU Nantes, 26922, Institut de Transplantation Urologie Néphrologie (ITUN), Nantes, Pays de la Loire, France; ., CHU Toulouse, 36760, Department of Nephrology and Organ Transplantation, Toulouse, France; ., CHU Nantes, 26922, Institut de Transplantation Urologie Néphrologie (ITUN), Nantes, Pays de la Loire, France; ., CHU Toulouse, 36760, Department of Urology, Kidney Transplantation and Andrology, Toulouse, France; ., CHU Toulouse, 36760, Department of Urology, Kidney Transplantation and Andrology, Toulouse, France; ., CHU Nantes, 26922, Institut de Transplantation Urologie Néphrologie (ITUN), Nantes, Pays de la Loire, France; ., CHU Toulouse, 36760, Department of Urology, Kidney Transplantation and Andrology, Toulouse, France; ., Centre Hospitalier Universitaire de Bordeaux Groupe hospitalier Pellegrin, 158435, Urology, Bordeaux, Aquitaine, France; ., CHU Nantes, 26922, Institut de Transplantation Urologie Néphrologie (ITUN), Nantes, Pays de la Loire, France; .