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Related Experiment Video

Updated: Jul 6, 2026

Surgical Treatment for Benign Prostatic Hyperplasia: Holmium Laser Enucleation of the Prostate HoLEP.
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Identification of Risk Factors for Postoperative Hypotension Following Transurethral Bladder Tumor Resection

Takashi Oshikawa1, Toyoaki Maruta1, Go Otao1

  • 1Department of Anesthesiology, University of Miyazaki Hospital, Miyazaki, JPN.

Cureus
|May 13, 2025
PubMed
Summary
This summary is machine-generated.

Postoperative hypotension after 5-aminolevulinic acid (5-ALA) transurethral resection of bladder tumors is linked to impaired kidney function and lower pre-anesthesia blood pressure. These factors increase the risk of hypotension following the procedure.

Keywords:
5-aminolevulinic acidbladder tumormultivariate analysispostoperative hypotensionspinal anesthesiatransurethral resection

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Area of Science:

  • Urology
  • Anesthesiology
  • Nephrology

Background:

  • 5-aminolevulinic acid (5-ALA) photodynamic therapy enhances bladder tumor visualization during transurethral resection (TUR-Bt).
  • Oral 5-ALA administration is associated with perioperative hypotension, but risk factors for postoperative hypotension remain unclear.

Purpose of the Study:

  • To identify risk factors for postoperative hypotension in patients undergoing TUR-Bt with 5-ALA.
  • To analyze these risk factors separately for general and spinal anesthesia.

Main Methods:

  • Retrospective analysis of 111 patients undergoing TUR-Bt with 5-ALA (July 2020 - December 2023).
  • Patients were grouped into hypotension (postoperative hypotension or vasopressor use) and non-hypotension groups.
  • Multivariate analysis identified risk factors, including estimated glomerular filtration rate (eGFR) and pre-operative mean blood pressure (mBP).

Main Results:

  • Impaired renal function (eGFR ≤ 45-60 mL/min/1.73 m² or eGFR < 45 mL/min/1.73 m²) and lower pre-operative mBP (< 95 mmHg) were significant risk factors for postoperative hypotension.
  • These findings were consistent across both general and spinal anesthesia subgroups, with spinal anesthesia also showing body mass index as a risk factor.

Conclusions:

  • Impaired renal function is a key risk factor for postoperative hypotension following 5-ALA TUR-Bt, irrespective of anesthesia type.
  • Maintaining adequate blood pressure before anesthesia may mitigate the risk of postoperative hypotension.