Evidence map›Paper›PMID 39382595›Full record

ArticleWorld journal of urology2024

General anesthesia is associated with lower perioperative bleeding and better functional outcomes than spinal anesthesia for endoscopic enucleation of the prostate: a single-center experience.

Carlo Silvani, Gianpaolo Lucignani, Carolina Bebi, Matteo Turetti, Francesco Ripa, Stefano Paolo Zanetti, Elisa De Lorenzis, Giancarlo Albo, Fabrizio Longo, Franco Gadda and 2 more

Registry-linked trialAbstract readComparative Study
PubMed Publisher
In one paragraph

Article in World journal of urology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07585552 (Does Anesthesia Type Affect HoLEP Outcomes? A Multi-Center, Real-World Comparative Study), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07585552 not yet recruitingnot on this mapstarted 2026, after this paper: background citation

Does Anesthesia Type Affect HoLEP Outcomes? A Multi-Center, Real-World Comparative Study

TypeobservationalSponsorOndokuz Mayıs UniversityRan2026 to 2027Enrolled320ConditionsBenign Prostatic Hyperplasia With Symptomatic Lower Urinary Tract Symptoms
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Carlo SilvaniDepartment of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Via della Commenda 15, Milan, 20122, Italy.
Gianpaolo LucignaniDepartment of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Via della Commenda 15, Milan, 20122, Italy.
Carolina BebiDepartment of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Via della Commenda 15, Milan, 20122, Italy.
Matteo TurettiDepartment of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Via della Commenda 15, Milan, 20122, Italy.
Francesco RipaDepartment of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Via della Commenda 15, Milan, 20122, Italy.
Stefano Paolo ZanettiDepartment of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Via della Commenda 15, Milan, 20122, Italy.
Elisa De LorenzisDepartment of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Via della Commenda 15, Milan, 20122, Italy.
Giancarlo AlboDepartment of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Via della Commenda 15, Milan, 20122, Italy.
Fabrizio LongoDepartment of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Via della Commenda 15, Milan, 20122, Italy.
Franco GaddaDepartment of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Via della Commenda 15, Milan, 20122, Italy.
Emanuele MontanariDepartment of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Via della Commenda 15, Milan, 20122, Italy.
Luca BoeriDepartment of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Via della Commenda 15, Milan, 20122, Italy. dr.lucaboeri@gmail.com.ORCID http://orcid.org/0000-0003-0040-784X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeHolmium laser enucleation of the prostate (HoLEP) and bipolar transurethral enucleation of the prostate (B-TUEP) are safe and effective treatment options for benign prostatic hyperplasia (BPH). Spinal anesthesia (SA) is widely used for endoscopic enucleation of the prostate (EEP) in place of general anesthesia (GA). We aimed to assess the impact of GA vs. SA on blood loss, postoperative course and functional outcomes after HoLEP and B-TUEP.

methodsAfter propensity score matching, we analyzed data from 148 patients treated with EEP in our centre for symptomatic BPH. We recorded patient's characteristics, procedural data, type of anesthesia (SA vs. GA). Postoperatively we evaluated hemoglobin drop, catheterization time (CT), and length of hospital stay (LOS). Functional outcomes were evaluated with the International Prostate Symptoms Score (IPSS) at baseline and 3 months after surgery. Descriptive statistics and linear regression models tested the association between anesthesia type and EEP outcomes.

resultsAfter matching groups were comparable in terms of pre- and intra-operative variables. Of all, 111 (75%) patients were treated under SA. Haemoglobin drop was lower in GA compared to SA group (1 vs. 1.4 g/dL, p < 0.01). CT was shorter in the GA group (1 vs. 2 days, p = 0.01). Postoperative IPSS score was lower in GA group (4 vs. 8, p = 0.04). Multivariable linear regression models revealed that prostate volume (p = 0.01) and SA vs. GA (p = 0.01) were associated with higher haemoglobin drop, after accounting for age and use of anticoagulants/antiplatelets. Similarly, SA vs. GA (p = 0.02) and postoperative complications occurrence (p < 0.001) were associated with a longer LOS, after accounting for age, prostate volume and use of anticoagulants/antiplatelets.

conclusionEEP can be safely performed under both GA and SA. GA offers better outcomes in terms of perioperative bleeding and 3-month functional outcomes.

Indexed as

Anesthesia, GeneralAnesthesia, SpinalBlood Loss, SurgicalProstatic HyperplasiaTransurethral Resection of ProstateAgedEndoscopyHumansLasers, Solid-StateLength of StayMaleMiddle AgedPropensity ScoreProstatectomyRetrospective StudiesTreatment OutcomeAnesthesiaComplicationsEndoscopic enucleationHolmium laserProstate

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.