Risk Factors of Emergency Room Visits for Bleeding Complications Following Transurethral Procedures in the Treatment of Benign Prostatic Hyperplasia: A Retrospective Cohort Study

Tzu-Chi Teng,1,2 I-Hung Shao,1,2 Yu-Chao Hsu,1,2 Yu Chen,1,2 Shu-Han Tsao,1,2 Yen-Te Kang,1,2 Ming-Li Hsieh1,2 1Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, 33302, Taiwan; 2College of Medicine, Chang Gung University, Taoyuan City, 33302, TaiwanCorres...

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Autores principales:	Teng TC, Shao IH, Hsu YC, Chen Y, Tsao SH, Kang YT, Hsieh ML
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	transurethral resection of prostate laser prostatectomy hematuria clot retention Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/364ba6627fa74d908c81125df29478df
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spelling	oai:doaj.org-article:364ba6627fa74d908c81125df29478df2021-12-02T18:10:28ZRisk Factors of Emergency Room Visits for Bleeding Complications Following Transurethral Procedures in the Treatment of Benign Prostatic Hyperplasia: A Retrospective Cohort Study1178-1998https://doaj.org/article/364ba6627fa74d908c81125df29478df2021-09-01T00:00:00Zhttps://www.dovepress.com/risk-factors-of-emergency-room-visits-for-bleeding-complications-follo-peer-reviewed-fulltext-article-CIAhttps://doaj.org/toc/1178-1998Tzu-Chi Teng,1,2 I-Hung Shao,1,2 Yu-Chao Hsu,1,2 Yu Chen,1,2 Shu-Han Tsao,1,2 Yen-Te Kang,1,2 Ming-Li Hsieh1,2 1Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, 33302, Taiwan; 2College of Medicine, Chang Gung University, Taoyuan City, 33302, TaiwanCorrespondence: Ming-Li Hsieh; I-Hung ShaoDivision of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, No. 5, Fuxing Street, Guishan District, Taoyuan City, 333423, TaiwanTel +886 975 365 568; +886 975 361311Fax +886-3-3274541Email h0810@cgmh.org.tw; b8902068@cgmh.org.twPurpose: Transurethral procedures, including transurethral resection of the prostate (TURP) and laser prostatectomy, are often linked to emergency room (ER) visits for postoperative bleeding. Although some studies have been conducted, the risk factors associated with these ER visits are not completely understood. This retrospective cohort study identified potential risk factors associated with ER visits for postoperative bleeding.Patients and Methods: Preoperative assessment data and operational and postoperational parameters recorded at Chang Gung Memorial Hospital, Taiwan between December 2015 and January 2017 for patients who underwent elective transurethral procedures were analyzed to identify potential risk factors. The primary endpoint was ER visits for gross hematuria within three months following operation, and the secondary endpoint was ER visits for blood clot-induced urinary retention (clot retention) within three months following operation.Results: A total of 665 patients who underwent elective transurethral procedures were enrolled. The transurethral procedures included monopolar transurethral resection of the prostate (M-TURP), bipolar TURP (B-TURP), greenlight photoselective vaporization of the prostate (PVP), thulium laser enucleation of the prostate (ThuLEP) and thulium laser transurethral vaporesection of the prostate (ThuVARP). Regarding ER visits for clot retention within three months, multivariable logistic regression revealed significantly lower rates of clot retention in patients who received B-TURP than in those who underwent ThuVARP (AOR, 0.18; 95% confidence interval [CI], 0.04– 0.82, p = 0.027). Moreover, significantly higher clot retention was observed in patients who underwent two or more rounds of manual irrigation (AOR, 9.51; 95% CI, 1.66– 54.43, p = 0.011).Conclusion: Multiple manual irrigations shortly after operation can be considered a novel predictor of postoperative clot retention-related ER visits. Among the transurethral procedures, ThuVARP was associated with a higher risk of clot retention-related ER visits than was B-TURP.Keywords: transurethral resection of prostate, laser prostatectomy, hematuria, clot retentionTeng TCShao IHHsu YCChen YTsao SHKang YTHsieh MLDove Medical Pressarticletransurethral resection of prostatelaser prostatectomyhematuriaclot retentionGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 16, Pp 1747-1756 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	transurethral resection of prostate laser prostatectomy hematuria clot retention Geriatrics RC952-954.6
spellingShingle	transurethral resection of prostate laser prostatectomy hematuria clot retention Geriatrics RC952-954.6 Teng TC Shao IH Hsu YC Chen Y Tsao SH Kang YT Hsieh ML Risk Factors of Emergency Room Visits for Bleeding Complications Following Transurethral Procedures in the Treatment of Benign Prostatic Hyperplasia: A Retrospective Cohort Study
description	Tzu-Chi Teng,1,2 I-Hung Shao,1,2 Yu-Chao Hsu,1,2 Yu Chen,1,2 Shu-Han Tsao,1,2 Yen-Te Kang,1,2 Ming-Li Hsieh1,2 1Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, 33302, Taiwan; 2College of Medicine, Chang Gung University, Taoyuan City, 33302, TaiwanCorrespondence: Ming-Li Hsieh; I-Hung ShaoDivision of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, No. 5, Fuxing Street, Guishan District, Taoyuan City, 333423, TaiwanTel +886 975 365 568; +886 975 361311Fax +886-3-3274541Email h0810@cgmh.org.tw; b8902068@cgmh.org.twPurpose: Transurethral procedures, including transurethral resection of the prostate (TURP) and laser prostatectomy, are often linked to emergency room (ER) visits for postoperative bleeding. Although some studies have been conducted, the risk factors associated with these ER visits are not completely understood. This retrospective cohort study identified potential risk factors associated with ER visits for postoperative bleeding.Patients and Methods: Preoperative assessment data and operational and postoperational parameters recorded at Chang Gung Memorial Hospital, Taiwan between December 2015 and January 2017 for patients who underwent elective transurethral procedures were analyzed to identify potential risk factors. The primary endpoint was ER visits for gross hematuria within three months following operation, and the secondary endpoint was ER visits for blood clot-induced urinary retention (clot retention) within three months following operation.Results: A total of 665 patients who underwent elective transurethral procedures were enrolled. The transurethral procedures included monopolar transurethral resection of the prostate (M-TURP), bipolar TURP (B-TURP), greenlight photoselective vaporization of the prostate (PVP), thulium laser enucleation of the prostate (ThuLEP) and thulium laser transurethral vaporesection of the prostate (ThuVARP). Regarding ER visits for clot retention within three months, multivariable logistic regression revealed significantly lower rates of clot retention in patients who received B-TURP than in those who underwent ThuVARP (AOR, 0.18; 95% confidence interval [CI], 0.04– 0.82, p = 0.027). Moreover, significantly higher clot retention was observed in patients who underwent two or more rounds of manual irrigation (AOR, 9.51; 95% CI, 1.66– 54.43, p = 0.011).Conclusion: Multiple manual irrigations shortly after operation can be considered a novel predictor of postoperative clot retention-related ER visits. Among the transurethral procedures, ThuVARP was associated with a higher risk of clot retention-related ER visits than was B-TURP.Keywords: transurethral resection of prostate, laser prostatectomy, hematuria, clot retention
format	article
author	Teng TC Shao IH Hsu YC Chen Y Tsao SH Kang YT Hsieh ML
author_facet	Teng TC Shao IH Hsu YC Chen Y Tsao SH Kang YT Hsieh ML
author_sort	Teng TC
title	Risk Factors of Emergency Room Visits for Bleeding Complications Following Transurethral Procedures in the Treatment of Benign Prostatic Hyperplasia: A Retrospective Cohort Study
title_short	Risk Factors of Emergency Room Visits for Bleeding Complications Following Transurethral Procedures in the Treatment of Benign Prostatic Hyperplasia: A Retrospective Cohort Study
title_full	Risk Factors of Emergency Room Visits for Bleeding Complications Following Transurethral Procedures in the Treatment of Benign Prostatic Hyperplasia: A Retrospective Cohort Study
title_fullStr	Risk Factors of Emergency Room Visits for Bleeding Complications Following Transurethral Procedures in the Treatment of Benign Prostatic Hyperplasia: A Retrospective Cohort Study
title_full_unstemmed	Risk Factors of Emergency Room Visits for Bleeding Complications Following Transurethral Procedures in the Treatment of Benign Prostatic Hyperplasia: A Retrospective Cohort Study
title_sort	risk factors of emergency room visits for bleeding complications following transurethral procedures in the treatment of benign prostatic hyperplasia: a retrospective cohort study
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/364ba6627fa74d908c81125df29478df
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Risk Factors of Emergency Room Visits for Bleeding Complications Following Transurethral Procedures in the Treatment of Benign Prostatic Hyperplasia: A Retrospective Cohort Study

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