Factors Associated With Early Recovery of Stress Urinary Incontinence Following Holmium Laser Enucleation of the Prostate in Patients With Benign Prostatic Enlargement

Abstract

PurposeTo investigate factors associated with early recovery of stress urinary incontinence (SUI) following holmium laser enucleation of the prostate (HoLEP) in patients with benign prostatic enlargement (BPE).MethodsThe medical records of 393 patients who underwent HoLEP for BPE were retrospectively reviewed. Patients with SUI following HoLEP were selected and divided into 2 groups: those who experienced early recovery of SUI and those who experienced persistent SUI. Recovery of SUI within 1 month after HoLEP was defined as early, and SUI that remained present after 1 month was defined as persistent. Preoperative clinical and urodynamic factors, as well as perioperative factors, were compared between groups.ResultsSUI following HoLEP was detected in 86 patients. Thirty-three patients exhibited recovery of SUI within 1 month, and SUI remained present in 53 patients after 1 month. Multivariate analysis showed that the transition zone prostate volume (odds ratio [OR], 5.354; 95% confidence interval [CI], 1.911–14.999; P=0.001) and the enucleation ratio (OR, 8.253; 95% CI, 1.786–38.126; P=0.007) were significantly associated with early recovery of SUI.ConclusionsEarly recovery of SUI within 1 month following HoLEP was associated with transition zone prostate volume and the enucleation ratio.

Robotic Simple Prostatectomy: Why and How?

“…For HoLEP, transient incontinence occurs in approximately 22% of cases. According to Cho et al [26], 18 patients, 4.6% of 393 patients who underwent HoLEP experienced urinary incontinence for longer than 3 months. The factors involved in urinary incontinence were transition zone prostate volume and the enucleation ratio.…”

Is Holmium Laser Enucleation of the Prostate a Good Surgical Alternative in Benign Prostatic Hyperplasia Management? A Review Article

“…44,50,51 Diabetes mellitus, longer operation and enucleation time, surgeon's experience, larger prostate size, higher blood loss are some factors associated with SUI after HoLEP. [52][53][54] Furthermore, the resection of tissue near the external sphincter might result in temporary UI. [52][53][54] The modified bilobar approach of HoLEP decreased the incidence of retrograde ejaculation and UI, improving the patients' quality of life after surgery compared to the traditional three-lobe technology.…”

“…[52][53][54] Furthermore, the resection of tissue near the external sphincter might result in temporary UI. [52][53][54] The modified bilobar approach of HoLEP decreased the incidence of retrograde ejaculation and UI, improving the patients' quality of life after surgery compared to the traditional three-lobe technology. 19 Multivariate analysis revealed that the prostate transition zone volume was significantly associated with the early recovery of SUI.…”

“…The patients with transition zone volume less than 30 mL may suffer from persistent stress urinary incontinence following HoLEP so other surgical techniques like bipolar TURP are a good choice for these patients. 52 Incidental Prostate Cancer A prostate biopsy is routinely performed to diagnose prostate cancer, but false negative results may be reported. [55][56][57][58] Different from other laser therapy for BPH, HoLEP is a surgical approach which provides a specimen for pathologic examination and therefore final specimen histology might disclose incidental prostate cancer (IPca).…”

Understanding of Neurological Diseases

“…In addition, the current issue of INJ contains clinical studies to offer useful information about specific treatment modalities, such as an analysis of risk factors for stress UI after holmium laser enucleation of the prostate [7], follow-up results of a new therapeutic device for anterior vaginal wall prolapse [8], and factors associated with successful sacral neuromodulation [9].…”