Abstract：
BACKGROUND: We aimed to determine if preoperative prostate volume-enucleated weight concordance predicts short-term anatomical endoscopic enucleation of the prostate (AEEP) outcomes using the REAP international database.
METHODS: 649 patients with data on both preoperative ultrasound-derived prostate volume and enucleated specimen weight were analyzed. Linear regression was used to investigate the effect of volume-weight concordance on postoperative outcomes. Model residuals were used to divide the cohort into 3 centiles: (1) less-than-expected enucleated specimen weight; (2) appropriate concordance between prostate volume and specimen weight; (3) more-than-expected specimen weight. Outcomes were also analyzed with only enucleated weight as a predictor (comparing ≤ 80 g and > 80 g).
RESULTS: There was a trend towards more-than-expected enucleated specimen weight with increased age (p = 0.006). There was an increasing trend of operation time (p = 0.012) and enucleation time (p = 0.015) as specimen weight increased, and a decreasing trend of postoperative acute urinary retention (p = 0.005). Laser type, enucleation method, and early apical release were similar. In correlation analysis, greater-than-expected prostate weight was associated with greater Qmax improvement at 3 months. Prostate weight alone did not appear to be a significant predictor of outcomes.
CONCLUSIONS: If enucleated specimen weight is more than expected according to preoperative ultrasound volume measurement, greater Qmax improvement and less postoperative acute urinary retention is expected. Although precision may be limited by ultrasound approximation and inexact specimen weight measurements, these shortcomings are similar in real-world clinical practice. Overall, preoperative prostate volume and actual enucleated specimen weight should be interpreted in the context of each other to predict clinical outcomes.
METHODS: 649 patients with data on both preoperative ultrasound-derived prostate volume and enucleated specimen weight were analyzed. Linear regression was used to investigate the effect of volume-weight concordance on postoperative outcomes. Model residuals were used to divide the cohort into 3 centiles: (1) less-than-expected enucleated specimen weight; (2) appropriate concordance between prostate volume and specimen weight; (3) more-than-expected specimen weight. Outcomes were also analyzed with only enucleated weight as a predictor (comparing ≤ 80 g and > 80 g).
RESULTS: There was a trend towards more-than-expected enucleated specimen weight with increased age (p = 0.006). There was an increasing trend of operation time (p = 0.012) and enucleation time (p = 0.015) as specimen weight increased, and a decreasing trend of postoperative acute urinary retention (p = 0.005). Laser type, enucleation method, and early apical release were similar. In correlation analysis, greater-than-expected prostate weight was associated with greater Qmax improvement at 3 months. Prostate weight alone did not appear to be a significant predictor of outcomes.
CONCLUSIONS: If enucleated specimen weight is more than expected according to preoperative ultrasound volume measurement, greater Qmax improvement and less postoperative acute urinary retention is expected. Although precision may be limited by ultrasound approximation and inexact specimen weight measurements, these shortcomings are similar in real-world clinical practice. Overall, preoperative prostate volume and actual enucleated specimen weight should be interpreted in the context of each other to predict clinical outcomes.
摘要：
背景：我们的目的是使用REAP国际数据库确定术前前列腺体积摘除重量的一致性是否可以预测短期解剖内镜前列腺摘除（AEEP）结果。
方法：分析了649例患者的术前超声前列腺体积和摘除标本重量的数据。线性回归用于研究体积-重量一致性对术后结局的影响。使用模型残差将队列分为3个百分位数：（1）小于预期的摘除样本重量；（2）前列腺体积与样本重量之间的适当一致性；（3）超过预期的样本重量。结果也仅以去核重量作为预测指标进行分析（比较≤80g和>80g）。
结果：随着年龄的增加，去核样本重量有超过预期的趋势（p=0.006）。手术时间(p=0.012)和摘除时间(p=0.015)随着标本重量的增加而有增加的趋势,术后急性尿潴留呈下降趋势(p=0.005)。激光类型,摘除法,和早期根尖释放相似。在相关分析中，前列腺重量高于预期与3个月时Qmax改善相关.单独的前列腺重量似乎并不是结果的重要预测因子。
结论：如果根据术前超声体积测量，摘除的标本重量超过预期，预计Qmax改善更大,术后急性尿潴留更少.尽管精度可能受到超声近似和不精确的样本重量测量的限制，这些缺点在现实世界的临床实践中是相似的。总的来说,术前前列腺体积和实际摘除的标本重量应相互解释,以预测临床结局.
方法：分析了649例患者的术前超声前列腺体积和摘除标本重量的数据。线性回归用于研究体积-重量一致性对术后结局的影响。使用模型残差将队列分为3个百分位数：（1）小于预期的摘除样本重量；（2）前列腺体积与样本重量之间的适当一致性；（3）超过预期的样本重量。结果也仅以去核重量作为预测指标进行分析（比较≤80g和>80g）。
结果：随着年龄的增加，去核样本重量有超过预期的趋势（p=0.006）。手术时间(p=0.012)和摘除时间(p=0.015)随着标本重量的增加而有增加的趋势,术后急性尿潴留呈下降趋势(p=0.005)。激光类型,摘除法,和早期根尖释放相似。在相关分析中，前列腺重量高于预期与3个月时Qmax改善相关.单独的前列腺重量似乎并不是结果的重要预测因子。
结论：如果根据术前超声体积测量，摘除的标本重量超过预期，预计Qmax改善更大,术后急性尿潴留更少.尽管精度可能受到超声近似和不精确的样本重量测量的限制，这些缺点在现实世界的临床实践中是相似的。总的来说,术前前列腺体积和实际摘除的标本重量应相互解释,以预测临床结局.
