MULTIFACTORIAL ANALYSIS OF HEMORRHAGIC RISK FACTORS IN ATHLETES UNDERGOING HOLMIUM LASER PROSTATECTOMY

Abstract

Background: Holmium laser prostatectomy (HoLEP) is a recognized treatment for benign prostatic hyperplasia (BPH), offering efficacy and safety. Despite its advantages, bleeding remains a significant concern that can impact patient outcomes. This study aims to identify factors influencing bleeding risks during HoLEP, particularly focusing on aspects relevant to athletes who may require such procedures. Objective: To evaluate various predictors of bleeding during HoLEP, including patient demographics, preoperative conditions, and surgical specifics, to optimize clinical outcomes and postoperative recovery, particularly for athletes. Methods: This cross-sectional study analyzed 400 patients who underwent HoLEP from January 2018 to December 2023. Data on patient characteristics, preoperative comorbidities, intraoperative parameters, and clinical outcomes were extracted from electronic medical records. Univariate and multivariate logistic regression analyses were performed to identify significant predictors of bleeding, defined as a reduction in hemoglobin by more than 3 g/dL or the need for blood transfusion. Results: Analysis identified significant predictors of bleeding as age, prostate volume, lower preoperative hemoglobin levels, operation duration, estimated blood loss, hypertension, and diabetes. Older age (>65 years), larger prostate size (>75 mL), lower preoperative hemoglobin (<130 g/L), longer surgery duration (>120 minutes), substantial estimated blood loss (>200 mL), and presence of hypertension and diabetes were confirmed as independent risk factors for significant bleeding during HoLEP. Conclusion: These risk factors necessitate a thorough preoperative assessment, particularly for athletes who might face unique challenges due to their physiological and health profiles. Enhanced intraoperative management and vigilant postoperative monitoring are crucial to mitigate bleeding risks and ensure rapid recovery and return to training. Future research should focus on prospective studies and clinical trials to further validate these findings and refine protocols to manage high-risk patients effectively, especially those engaged in sports, to tailor interventions that minimize bleeding risks.