of patients. LUTS medication including anticholinergics and alphablockers were present in 23 patients (2.6%), whereas 9 patients (1%) had an indwelling catheter. 19 (1.9%) of patients required reoperation, permanent urinary incontinence was present in 20 (2.2%) of patients. Stratification by duration of follow-up (1st, 2nd, 3rd, 4th quartile 6-31 months, 32-51 months, 52-78 months, 79-124 months, respectively) revealed significant differences with respect to QoL (1 (IQR 0-1) vs. 1 (IQR 1-2)) and any permanent urinary incontinence (4 patients (1.8%) vs. 7 patients (3.1%)) in the 1st vs. 4th follow-up quartile. No significant differences were observed with respect to PSA, IPSS, LUTS medication, presence of an indwelling catheter, or rates of resurgery (all p>0.1). In multivariable analysis age at surgery (odds ratio (OR) 1.04 (95% Confidence Interval (CI) 1.01-1.07), p[0.003), prostate volume (OR 0.99 (95%CI 0.98-0.99), p[0.029), BMI (OR 1.06 (95%CI 1.0-1.1), p[0.035), presence of indwelling catheter prior to surgery (OR 0.51 (95%CI 0.32-0.82), p[0.003), and anticholinergic medication prior to surgery (OR 1.74 (95%CI 1.01-3.0), p[0.003) were independent predictors of persistent/recurring symptoms.CONCLUSIONS: Our experience confirms overall durable and excellent outcomes after HoLEP. Yet, a non-negligible fraction of patients with persistent/recurring LUTS highlights the need for optimizing patient selection and utilizing individualized treatments among the growing armamentarium of surgical options.
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