Abstract：
OBJECTIVE: To evaluate factors that effectively predict indistinct plane (IP) in patients who underwent holmium laser enucleation of the prostate (HoLEP).
METHODS: Data of 208 consecutive patients from our HoLEP database were reviewed and analyzed. IP was defined in 107 cases, as the plane could be identified only depending on endoscopic beak dissection rather than laser dissection in the initial stage of HoLEP, whereas the control group consisted of 101 cases. Variables including age, body mass index, prostatic volume (PV), intravesical prostatic protrusion, prostate-specific antigen, prostate-specific antigen density, bladder stones, urinary tract infection, microscopic hematuria, prior biopsy (PB), diabetes, hypertension, history of acute urinary retention, 5-alpha reductase inhibitor treatment, catheter dependency, residual urine, region, smoking, and alcohol consumption were compared between the two groups. The risk factors for predicting the presence of IP were determined using a multivariable binary logistic regression model using a forward selection approach with a focus on improvement in the area under the receiver operating characteristic curve (AUC).
RESULTS: The incidence of IP was 51.4% (107/208). PV (OR = 0.977, p < 0.001) and PB (OR = 0.297, p = 0.028) were identified as the independent predictors of capsule plane status. PV with a cutoff of 54 ml had the best predictive effectiveness for IP based on AUC (0.727; 95% CI 0.659-0.795). The specificity and sensitivity of this cutoff were 82.2% and 53.3%, respectively.
CONCLUSIONS: PV is the most reliable factor to predict IP during HoLEP procedures. There is a high possibility of IP in patients with a PV less than 54 ml.
METHODS: Data of 208 consecutive patients from our HoLEP database were reviewed and analyzed. IP was defined in 107 cases, as the plane could be identified only depending on endoscopic beak dissection rather than laser dissection in the initial stage of HoLEP, whereas the control group consisted of 101 cases. Variables including age, body mass index, prostatic volume (PV), intravesical prostatic protrusion, prostate-specific antigen, prostate-specific antigen density, bladder stones, urinary tract infection, microscopic hematuria, prior biopsy (PB), diabetes, hypertension, history of acute urinary retention, 5-alpha reductase inhibitor treatment, catheter dependency, residual urine, region, smoking, and alcohol consumption were compared between the two groups. The risk factors for predicting the presence of IP were determined using a multivariable binary logistic regression model using a forward selection approach with a focus on improvement in the area under the receiver operating characteristic curve (AUC).
RESULTS: The incidence of IP was 51.4% (107/208). PV (OR = 0.977, p < 0.001) and PB (OR = 0.297, p = 0.028) were identified as the independent predictors of capsule plane status. PV with a cutoff of 54 ml had the best predictive effectiveness for IP based on AUC (0.727; 95% CI 0.659-0.795). The specificity and sensitivity of this cutoff were 82.2% and 53.3%, respectively.
CONCLUSIONS: PV is the most reliable factor to predict IP during HoLEP procedures. There is a high possibility of IP in patients with a PV less than 54 ml.
摘要：
目的：评估有效预测前列腺钬激光剥除术（HoLEP）患者平面模糊（IP）的因素。
方法：回顾并分析了我们HoLEP数据库中208例连续患者的数据。在107例病例中定义了IP，因为在HoLEP的初始阶段，只能根据内窥镜喙解剖而不是激光解剖来识别飞机，而对照组为101例。变量包括年龄，身体质量指数,前列腺体积（PV），膀胱内前列腺突出，前列腺特异性抗原,前列腺特异性抗原密度,膀胱结石,尿路感染,镜下血尿,先前的活检（PB），糖尿病,高血压,急性尿潴留的病史，5-α还原酶抑制剂治疗，导管依赖性,残余尿液,区域,吸烟,比较两组的饮酒量。使用多变量二元逻辑回归模型，使用前向选择方法确定预测IP存在的风险因素，重点是改善受试者工作特征曲线（AUC）下的面积。
结果：IP的发生率为51.4%(107/208)。PV（OR=0.977，p<0.001）和PB（OR=0.297，p=0.028）被确定为囊平面状态的独立预测因子。基于AUC（0.727；95％CI0.659-0.795），截断值为54ml的PV对IP具有最佳预测效果。该截断值的特异性和敏感性分别为82.2%和53.3%,分别。
结论：PV是预测HoLEP过程中IP的最可靠因素。在PV小于54ml的患者中IP的可能性很高。
方法：回顾并分析了我们HoLEP数据库中208例连续患者的数据。在107例病例中定义了IP，因为在HoLEP的初始阶段，只能根据内窥镜喙解剖而不是激光解剖来识别飞机，而对照组为101例。变量包括年龄，身体质量指数,前列腺体积（PV），膀胱内前列腺突出，前列腺特异性抗原,前列腺特异性抗原密度,膀胱结石,尿路感染,镜下血尿,先前的活检（PB），糖尿病,高血压,急性尿潴留的病史，5-α还原酶抑制剂治疗，导管依赖性,残余尿液,区域,吸烟,比较两组的饮酒量。使用多变量二元逻辑回归模型，使用前向选择方法确定预测IP存在的风险因素，重点是改善受试者工作特征曲线（AUC）下的面积。
结果：IP的发生率为51.4%(107/208)。PV（OR=0.977，p<0.001）和PB（OR=0.297，p=0.028）被确定为囊平面状态的独立预测因子。基于AUC（0.727；95％CI0.659-0.795），截断值为54ml的PV对IP具有最佳预测效果。该截断值的特异性和敏感性分别为82.2%和53.3%,分别。
结论：PV是预测HoLEP过程中IP的最可靠因素。在PV小于54ml的患者中IP的可能性很高。
