{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T04:18:50Z","timestamp":1792729130769,"version":"4.5.0"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T00:00:00Z","timestamp":1700438400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To analyze the incidence and risk factors of intraoperative hypotension related to photodynamic diagnosis\u2010assisted transurethral resection of bladder tumor (PDD\u2010TURBT) with oral 5\u2010aminolevulinic acid (5\u2010ALA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analyzed 487 patients with bladder tumors who underwent PDD\u2010TURBT (<jats:italic>n<\/jats:italic>\u2009=\u2009184) or conventional TURBT (conv\u2010TURBT) (<jats:italic>n<\/jats:italic>\u2009=\u2009303) between 2018 and 2021. Intraoperative hypotension was defined as hypotension requiring vasopressors during TURBT, and its incidence was compared between the two groups. Potential risk factors of intraoperative hypotension, including preoperative change in mean arterial pressure (MAP), were further investigated in patients receiving PDD\u2010TURBT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median age was 72\u2009years, 392 patients (81%) were male, and 203 (42%) had hypertension. TURBT was performed under general and spinal anesthesia in 76 (16%) and 411 (84%) patients, respectively. The incidence of intraoperative hypotension was significantly higher in PDD\u2010TURBT compared to conv\u2010TURBT (43% vs. 17%, respectively). The median change in MAP until the induction of anesthesia was +6.5\u2009mmHg (range: \u221229.0 to +46.3) in the PDD\u2010TURBT group and +14.7\u2009mmHg (range: \u221235.3 to +67.7) in the conv\u2010TURBT group, showing a significantly smaller increase in the PDD\u2010TURBT group (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). In the multivariable analysis for PDD\u2010TURBT patients, advanced age, general anesthesia, and lower MAP change (&lt;+6.5\u2009mmHg) until anesthesia induction were significantly associated with intraoperative hypotension (<jats:italic>p<\/jats:italic>\u2009=\u20090.0104, &lt;0.001, and &lt;0.001, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Intraoperative hypotension occurred more frequently in patients who underwent PDD\u2010TURBT than in those who underwent conv\u2010TURBT. Using oral 5\u2010ALA decreases preoperative blood pressure elevation and may be responsible for intraoperative hypotension.<\/jats:p><\/jats:sec>","DOI":"10.1111\/iju.15341","type":"journal-article","created":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T23:06:34Z","timestamp":1700607994000},"page":"238-244","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Incidence and predictors of intraoperative hypotension during transurethral bladder tumor resection with oral 5\u2010aminolevulinic acid"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7118-5522","authenticated-orcid":false,"given":"Yudai","family":"Ishikawa","sequence":"first","affiliation":[{"name":"Department of Urology Tokyo Medical and Dental University  Bunkyo\u2010ku Tokyo 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