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Poster 2: BPH
prostate (HoLEP), or photoselective vaporization of the prostate (PVP) with no IV Abs (p=0.82). Choices of IV Abs used on induction for IDC-
were retrospectively reviewed. Patients were included only if they had dependent TURP is shown in Figure 1, illustrating significant variability.
detrusor overactivity and postvoid residual <150 ml. Patients’ character- Conclusions: Patients with an IDC prior to undergoing a TURP have a
istics, preoperative urodynamics study (UDS) parameters, preoperative significantly high incidence of culture-proven UTIs. Preoperative intra-
and postoperative OAB symptomatology, International Prostate Symptom venous Abs and IDC change prior to a TURP could reduce their risk of
Score (IPSS), procedure complications, and postoperative need for treat- readmission. There is also significant variability in the choice of Abs used
ment were collected, analyzed, and compared. during induction. More research is warranted in this area to establish
Results: A total of 170 BPH patients with OAB symptoms were divided clear guidelines.
into three groups based on their BPH intervention: TURP (89 patients), References
HoLEP (64 patients), and PVP (17 patients). Urgency (p=0.031) and urge 1. Lawson K, Rudzinski J, Vicas I, et al. Assessment of antibiotic
incontinence (p=0.004) were significantly improved in the HoLEP and prophylaxis prescribing patterns for TURP: A need for Canadian
PVP groups compared to the TURP group at three months postoperative. guidelines? Can Urol Assoc J 2013;7:e530-6. https://doi.
At three and six months, there were significant improvements of all OAB org/10.5489/cuaj.205
symptoms in comparison to preoperative parameters (Table 1).
Conclusions: TURP, HoLEP, and PVP are effective and reliable surgical UP-2.6
procedures that can be used for BPH patients with OAB symptoms.
Compared to TURP, HoLEP and PVP provide better improvement in Safety and efficacy of GreenLight photoselective vaporization
urgency and urge incontinence. of the prostate in octogenarians using the Global GreenLight
Group database
Claudia Deyirmendjian , David-Dan Nguyen , David Bouhadana , Kyle
1
2
2
UP-2.5 Law , Naeem Bhojani , Dean Elterman , Bilal Chughtai , Franck Bruyère ,
3
3
4
6
5
Perioperative antibiotics for transurethral resection of prostate Luca Cindolo , Giovanni Ferrari , Carlos Vasquez-Lastra , Tiago Borelli-
7
7
8
in indwelling catheter dependence Bovo , Edgardo F Becher , Hannes Cash , Maximilian Reimann , Enrique
9
11
12
10
Dhanika Samaranayake , Trent Pattenden , Morton Andrew , Jonathan Rijo , Vincent Misrai , Kevin Zorn 3
1
1
1
14
13
Chambers 1 1 Faculty of Medicine, Université de Montréal, Montreal, QC, Canada;
1 Department of Urology, Ipswich Hosptial, Queensland, Australia 2 Faculty of Medicine and Health Sciences, McGill University, Montreal,
Introduction: The literature suggests that having an indwelling catheter QC, Canada; Division of Urology, Centre hospitalier de l’université de
3
(IDC) prior to transurethral resection of the prostate (TURP) is closely Montréal, Montreal, QC, Canada; Division of Urology, University Health
4
associated with an increased risk of postoperative urinary tract infection Network, Toronto, ON, Canada; Department of Urology, Weill Cornell
5
(UTI). Although guidelines strongly recommend antibiotic prophylaxis for Medical College, New York, NY, United States; Department of Oncology
6
TURP, the use of antibiotic prophylaxis in patients with preoperative IDC and Urology, Centre Hospitalier Universitaire de Tours, Centre-Val de
remains unclear. The aim of this study was to retrospectively evaluate Loire, France; Department of Urology, Hesperia Hospital, Modena, Italy;
1
7
preoperative antimicrobial therapy in patients undergoing TURP for IDC 8 Department of Urology, ABC Medical Center, Mexico City, , Mexico;
dependence and post-operative UTI outcomes. 9 Department of Urology, Ribeirão Presto, Sao Paulo, Brazil; Centro
10
Methods: A retrospective chart review of 53 patients undergoing TURP de Urologia, CDU, Buenos Aires, Argentina; Prouro, Urology, Berlin,
11
was performed. Electronic medical records of these patients were reviewed Germany; Department of Urology, Charité – Universitaetsmedizin Berlin,
12
for IDC dependence, preoperative UTI, preoperative antimicrobial man- Berlin, Germany; Department of Urology, Hospital Quiron Barcelona,
13
agement, and 30-day admissions with UTI. Exclusion criteria were any Barcelona, Spain; Department of Urology, Clinique Pasteur, Toulouse,
14
additional procedures at the time of the TURP and postoperative IDC France
for >7 days. Introduction: GreenLight photoselective vaporization of the prostate (PVP)
Results: Out of the 53 charts reviewed, three patients were excluded for is a surgical treatment for benign prostatic hyperplasia (BPH) that yields
IDC >7 days and additional procedures. The mean age was 68 years. comparable results to transurethral resection of the prostate while opti-
Preoperative IDC was present in 24 patients. Positive preoperative culture mizing safety outcomes; yet, granular data is lacking for patients over the
was found in 83% of IDC-dependent patients and 80% were treated with age of 80. The present study analyzed the largest international GreenLight
oral antibiotics (Abs). IV Abs in the 24 hours prior to surgery was given database, the Global GreenLight Group, to evaluate the functional and
to 79% of IDC-dependent cases, along with a change of catheter. All safety profile of GreenLight PVP in octogenarians.
patients received an induction dose of IV Abs; only two patients received Methods: The Global GreenLight Group is a database comprised of
induction IV Abs alone. Readmission with UTI within 30 days was 16% in patients that underwent GreenLight PVP from 2011–2019 performed by
IDC-dependent patients receiving preoperative IV Abs compared to 20% eight experienced urologists at seven different international hospitals.
Patients 80 years or older at the time of surgery were categorized as
octogenarians, and were compared to all other PVP patients, labelled
as the control group.
Results: Among 3648 patients, 586 men were above the age of 80.
Compared to the control, octogenarians had larger prostates (76.0 vs.
71.9 ml, p=0.02) and a lower body mass index (25.6 vs. 26.7, p=0.045).
They also had higher American Society of Anesthesiologists scores: 61.0%
were considered high-medical-risk, i.e., had an ASA of 3 or greater, com-
pared to 22.7% in the control group. Operative time was not significantly
longer. The change in outcomes between 80-year-old patients and con-
trol patients was not significantly different one-year postoperative, with
the exception of maximum urinary flow that favored younger patients
(Table 1). The odds of transfusion were greater for older patients (odds
ratio 8.2, 95% confidence interval 3.6–18.9, p<0.01) but they were not
at increased risk of hematuria. Octogenarians had higher readmission
rates (23.0% vs. 11.9%, p<0.01).
Conclusions: GreenLight PVP is an effective surgical option for treat-
ing symptomatic BPH in octogenarians and achieves similar functional
UP-2.5. Figure 1. Pie chart of antibacterial prophylaxis for IDC-dependent outcomes compared to younger patients. The odds of transfusion were
TURP patients.
CUAJ • June 2022 • Volume 16, Issue 6(Suppl1) S37