AI Summary & Key Takeaways
AI InsightThis type of anesthesia may be preferred for use in elderly patients with BPH/LUTS who cannot tolerate general and/or regional anesthesia due to comorbidities.
📌 3 Key Takeaways
Özet
Introduction: GreenLight® photoselective vaporization of the prostate (PVP) is an effective minimally invasive surgical treatment for lower urinary tract symptoms suggestive of benign prostatic hyperplasia (BPH/LUTS). This study aimed to assess the feasibility of using local anesthesia during the 180-Watt GreenLight® PVP procedure in patients who are unsuitable for general or regional anesthesia. Methods: The study involved 52 patients who underwent PVP using the 180-Watt GreenLight® system at our institution under periprostatic block between December 2013 and August 2015. All patients completed International Prostate Symptom Score (IPSS) and underwent uroflowmetric evaluation to determine maximum flow rate (Qmax). Post-void residual urine and prostate volumes were measured by transpubic and transrectal ultrasonography, respectively. Before the operation, 20 ml of bupivacaine hydrochloride (5 mg/ml) was injected into the prostate capsule through the perineum using a 22 G Spinocan® needle under the guidance of an index finger inserted into the rectum. Following the procedure, each patient was assessed for pain using the visual analog scale (VAS), and all patients were followed up 3 months after surgery. Results: Mean patient age was 74.88±7.16 years. All operations were successfully completed without the need to convert to general anesthesia. PVP resulted in a significant improvement in IPSS (28.6±3.83 vs. 10.73±2.62, p<0.0001) and Qmax (6.88±1.1 vs. 23.87±2.8, p<0.0001). Mean operative time, indwelling catheter duration, and length of hospital stay were 57.13±15.32 min, 1.25±0.44 days, and 1.37±0.56 days, respectively. No severe perioperative complications were recorded. The majority of patients did not exhibit any evidence of pain during the procedure (46 of 52 patients had a VAS of 0), and the mean VAS score was 0.40±1.27. Discussion and Conclusion: Periprostatic block appears to be a feasible and safe alternative to general or regional anesthesia during PVP using a 180-Watt GreenLight® system. This type of anesthesia may be preferred for use in elderly patients with BPH/LUTS who cannot tolerate general and/or regional anesthesia due to comorbidities.