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Erschienen in: Zeitschrift für Gerontologie und Geriatrie 5/2015

01.07.2015 | Originalien

Potenzielle kognitive Veränderungen nach Behandlung des benignen Prostatasyndroms

Untersuchungen zu transurethraler Elektroresektion oder 180-Watt-XPSTM-Greenlight-Laserung

verfasst von: M.D. PD Dr. A. Wiedemann, R. Maykan, J. Pennekamp, Dr. J. Hirsch, Prof. Dr. med. H. Heppner

Erschienen in: Zeitschrift für Gerontologie und Geriatrie | Ausgabe 5/2015

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Zusammenfassung

Hintergrund

Veränderungen der Kognition des Patienten nach transurethraler Resektion der Prostata (TURP) im Vergleich zur 180-W-GreenLight-XPS™-Laserung der Prostata sollten erfasst werden. Diese waren bisher nicht untersucht.

Methoden

Hierzu wurden die „Mini-mental State Examination“ (MMSE) und der „Uhrentest“ nach Schulman präoperativ und am 2. postoperativen Tag neben klinischen Parametern wie Patientenalter, Prostatagröße, Operationsdauer, Begleiterkrankungen, Komedikation, Veränderungen der Hämoglobin(Hb)- und Natriumkonzentration erfasst.

Ergebnisse

Die mithilfe der TURP (n = 88) und der 180-W-GreenLight-XPS™-Laserung der Prostata (n = 114) operierten Patienten waren hinsichtlich des Alters, der Prostatagröße und der Operationszeit vergleichbar. Gelaserte Patienten wiesen bezüglich potenzieller postoperativer kognitiver Veränderungen mit im Mittel 3,8 Begleiterkrankungen (TURP: 3,11; p = 0,005) und mit der Einnahme von 6,79 Medikamenten (TURP: 5,24; p < 0,001) ein erhöhtes Risikopotenzial auf. Weder für die MMSE noch für den Uhrentest kam es zu einem verschlechterten postoperativen Punktwert (post- und präoperative Differenz: MMSE + 0,6 ± 1,6 für die 180-W-GreenLight-XPS™-Laserung der Prostata und  + 0,6 ± 1,6 für die TURP, p = 0,944; post- und präoperative Differenz: Uhrentest  + 0,43 ± 1,44 für die 180-W-GreenLight-XPS™-Laserung der Prostata und 0,13 ± 1,17 für die TURP, p = 0,097). Für sicherheitsrelevante Parameter wie postoperative Hb- oder postoperative Natriumkonzentration konnten klinisch relevante Veränderungen nicht nachgewiesen werden.

Diskussion

Weder für die 180-W-GreenLight-XPS™-Laserung der Prostata noch für die TURP ließen sich Veränderungen der Kognition durch den Vergleich der präoperativen MMSE oder den Uhrentest nachweisen. Da in der vorliegenden Untersuchung die gelaserten Patienten mit einer höheren Zahl von Begleiterkrankungen, einer vermehrten Einnahme von Medikamenten, insbesondere mit anticholinerger Potenz, ein höheres Risikopotenzial aufwiesen, erscheint die 180-W-GreenLight-XPS™-Laserung der Prostata für derart zu charakterisierende Patienten besonders sicher.
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Metadaten
Titel
Potenzielle kognitive Veränderungen nach Behandlung des benignen Prostatasyndroms
Untersuchungen zu transurethraler Elektroresektion oder 180-Watt-XPSTM-Greenlight-Laserung
verfasst von
M.D. PD Dr. A. Wiedemann
R. Maykan
J. Pennekamp
Dr. J. Hirsch
Prof. Dr. med. H. Heppner
Publikationsdatum
01.07.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Zeitschrift für Gerontologie und Geriatrie / Ausgabe 5/2015
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269
DOI
https://doi.org/10.1007/s00391-014-0819-2