TY  - EJOU
AU  - Elsherbini, Tawfik 
AU  - Bouhadana, David 
AU  - Sadri, Iman 
AU  - Nguyen, David-Dan 
AU  - Law, Kyle W. 
AU  - Arezki, Adel 
AU  - Deyirmendjian, Claudia 
AU  - Ibrahim, Ahmed 
AU  - Bhojani, Naeem 
AU  - Elterman, Dean S. 
AU  - Chughtai, Bilal 
AU  - Bruyère, Franck 
AU  - Cindolo, Luca 
AU  - Ferrari, Giovanni 
AU  - Vasquez-Lastra, Carlos 
AU  - Borelli-Bovo, Tiago 
AU  - Becher, Edgardo F. 
AU  - Cash, Hannes 
AU  - Reimann, Maximillian 
AU  - Rijo, Enrique 
AU  - Misrai, Vincent 
AU  - Zorn, Kevin C. 

TI  - The impact of 5-ARI on perioperative and  functional outcomes of GreenLight PVP: an analysis of the Global GreenLight Group  database
T2  - Canadian Journal of Urology

PY  - 2023
VL  - 30
IS  - 2
SN  - 1488-5581

AB  - <b>Introduction:</b> In this study, we sought to investigate the impact of 5-alpha reductase inhibitors (5-ARI) on the perioperative and functional outcomes of 180-Watt XPS GreenLight photovaporization of the prostate (PVP) using a large international database.<br/>
<b>Materials and methods:</b> Data were obtained from the Global GreenLight Group (GGG) database, which includes eight high-volume, experienced surgeons from seven international centers. All men with established benign prostatic hyperplasia (BPH) with known 5-ARI status who underwent GreenLight PVP using the XPS-180W system between 2011 and 2019 were eligible for the study. Patients were assigned to two groups based on the preoperative use of 5-ARI. Analyses were adjusted for patient age, prostate volume, and American Society of Anesthesia (ASA) score.<br/>
<b>Results:</b> We included 3,500 men, of which 1,246 (36%) had preoperative 5-ARI use. Patients in both groups were similar with regards to age and prostate size. On multivariable analysis, total operative time was slightly shorter (-3.26 min 95% CI: 1.20 — 5.32, p < 0.01) and required 35.6kJ less laser energy (95% CI: -48.0kJ — -23.3kJ, p < 0.01) for patients on 5ARI compared to those without 5-ARI. However, no clinically significant difference was appreciated regarding postoperative transfusion rates [OR 0.048 (95% CI -0.82-0.91; p = 0.91)], hematuria rates [OR 0.96 (95% CI 0.72-1.3; p = 0.81)], 30-day readmission rates [OR 0.98 (95% CI 0.71-1.4; p = 0.90)], or overall functional outcomes.<br/>
<b>Conclusion:</b> Our findings suggest that preoperative 5-ARI is not associated with any clinically significant different perioperative or functional outcomes for GreenLight PVP using the XPS-180W system. There is no role for the initiation or discontinuation of 5-ARI prior to GreenLight PVP.
KW  - GreenLight PVP
KW  -  BPH
KW  -  5-ARI

DO  -