Incidental XXXX Diagnosis During Holmium Laser Enucleation: Assessment of Predictors, Survival, and Disease Progression.

@entity1 @entity263 @entity5 @entity420 @entity1486
OBJECTIVE: To determine the prevalence and predictors of @entity263 ( @entity263 ) after Holmium laser enucleation of the prostate (HoLEP) and to assess its functional and oncological outcomes. METHODS: A prospectively maintained database was reviewed for cases with @entity263 at the time of HoLEP. @entity1 with preoperative PCa were excluded. @entity1 were divided into two groups based on the presence (group I [GI]) or absence of @entity5 (group II [GII]) in histopathology. Univariate and multivariate logistic regression analyses were performed. RESULTS: Of 1242 @entity1 , 70 (5.64%) were identified to have @entity263 . Prostate size was comparable between both groups. GI @entity1 had significantly higher preoperative @entity1486 (PSA) and total PSA density (tPSAD) compared to @entity5 -free @entity1 . T1a and T1b @entity420 were detected in 54 (77.1%) and 16 (22.9%) @entity1 , respectively. After a median follow-up of 48 (1-171) months, both groups were comparable in all functional outcomes but the quality of life was significantly better in GII. @entity1 ' age and preoperative tPSAD independently predicted @entity263 after HoLEP. A tPSAD cutoff value of 0.092 has a sensitivity and specificity of 0.83 and 0.67, respectively. Seven @entity1 (11.7%) needed adjuvant therapy while other GI @entity1 opted for active surveillance. The Kaplan-Meier analysis demonstrated an overall survival of 72.8% at 5 years and 63.5% at 10 years for @entity1 with PCa. CONCLUSION: PCa is not uncommonly identified after HoLEP, even in those with negative preoperative biopsies. In older @entity1 , total PSAD could be a predictor using a cutoff <0.1. After HoLEP, active surveillance for low-grade PCa carries good functional and oncological outcomes.
