Incidence and risk factors for postoperative urinary incontinence after various prostate enucleation procedures: systemic review and meta-analysis of PubMed literature from 2000 to 2021

Hout, M.B.A. van; Gurayah, Aaron; Arbeláez, María Camila Suárez; Blachman‐Braun, Ruben; Shah, Khushi; Herrmann, Thomas; Shah, Hemendra N.

doi:10.1007/s00345-022-04174-1

Cited by 15 publications

(2 citation statements)

References 77 publications

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“…Several factors with the controversy between the reported studies have increased the risk of UI after BPH surgery. Of them, advanced age, higher body mass index (>30), higher preoperative IPSS, uncontrolled diabetes, longer operative time (>100 minutes), increased surgical enucleation weight, and intraoperative blood loss (>2.5 g/dL) can be mentioned 15,16 . Other reported factors include urethral membrane length, higher detrusor voiding pressure, and abnormal baseline urodynamic parameters 17 .…”

Section: Discussionmentioning

confidence: 99%

Influence of urethral mucosa preservation of prostatic apex during monopolar transurethral resection of the prostate on postoperative functional outcomes: A retrospective comparative study

Irani,

Saadatfar,

Aminsharifi

et al. 2024

Urological Science

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Purpose: The aim of this study is to compare the efficacy and functional outcomes of monopolar transurethral resection of the prostate (m-TURP) without and with the preservation of urethral mucosa at the prostatic apex. Materials and methods: In a retrospective study from June 2018 to June 2020, 53 patients with benign prostatic hyperplasia who undertook m-TURP were included in the study. The patients who underwent conventional m-TURP were considered group A (n = 26) and those who were operated by m-TURP with preserved prostate apex were considered group B (n = 27). Preoperative and operative parameters, postoperative complications, urinary incontinence (UI), postoperative 6-month functional outcomes including International Prostate Symptom Score, International Index of Erectile Function score, and peak flow rates (Q max) were assessed and compared between groups. Results: All preoperative parameters were similar in both groups without significant differences (P > 0.05). In group A, the mean operative time was significantly longer (40.59 ± 5.20 versus 33.84 ± 4.44 minutes), and intraoperative blood loss was significantly more (305 ± 63.4 versus 212.5 ± 65 mL) than in group B and both were statistically significant (P < 0.001 and P < 0.0001, respectively). Group B had significantly lower urge UI compared with group A (0% versus 23%; P = 0.008). Six-month follow-up data showed that the International Prostate Symptom Score, International Index of Erectile Function score, and Q max were improved in both groups with no statistically significant differences between the 2 groups (P > 0.05). Conclusion: Our results indicate that preservation of urethral mucosa at the prostatic apex can be associated with a lower incidence of early postoperative urge UI, less operative blood loss, and shorter operative length, thus improving surgical efficiency.

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Section: Discussionmentioning

confidence: 99%

Influence of urethral mucosa preservation of prostatic apex during monopolar transurethral resection of the prostate on postoperative functional outcomes: A retrospective comparative study

Irani,

Saadatfar,

Aminsharifi

et al. 2024

Urological Science

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“… 4 The pooled incidence of 6-month stress urinary incontinence (SUI), urge urinary incontinence (UUI), and mixed urinary incontinence (MUI) after EEP has been reported to be 6.0%, 7.3%, and 0.8%, respectively, 5 with no difference among different energy sources. 6 Incontinence following EEP is commonly transient with most cases resolving within 1 month to 6 months and could be secondary to more complete tissue removal leading to partial weakening or stretching of the external sphincter. 7 …”

Section: Introductionmentioning

confidence: 99%

Incidence of urinary incontinence following endoscopic laser enucleation of the prostate by en-bloc and non-en-bloc techniques: a multicenter, real-world experience of 5068 patients

Castellani,

Gauhar,

Fong

et al. 2024

Asian Journal of Andrology

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We aim to evaluate the incidence of incontinence following laser endoscopic enucleation of the prostate (EEP) comparing en-bloc (Group 1) versus 2-lobe/3-lobe techniques (Group 2). We performed a retrospective review of patients undergoing EEP for benign prostatic enlargement in 12 centers between January 2020 and January 2022. Data were presented as median and interquartile range (IQR). Univariable and multivariable logistic regression analysis was performed to evaluate factors associated with stress urinary incontinence (SUI) and mixed urinary incontinence (MUI). There were 1711 patients in Group 1 and 3357 patients in Group 2. Patients in Group 2 were significantly younger (68 [62–73] years vs 69 [63–74] years, P = 0.002). Median (interquartile range) prostate volume (PV) was similar between the groups (70 [52–92] ml in Group 1 vs 70 [54–90] ml in Group 2, P = 0.774). There was no difference in preoperative International Prostate Symptom Score, quality of life, or maximum flow rate. Enucleation, morcellation, and total surgical time were significantly shorter in Group 1. Within 1 month, overall incontinence rate was 6.3% in Group 1 versus 5.3% in Group 2 (P = 0.12), and urge incontinence was significantly higher in Group 1 (55.1% vs 37.3% in Group 2, P < 0.001). After 3 months, the overall rate of incontinence was 1.7% in Group 1 versus 2.3% in Group 2 (P = 0.06), and SUI was significantly higher in Group 2 (55.6% vs 24.1% in Group 1, P = 0.002). At multivariable analysis, PV and IPSS were factors significantly associated with higher odds of transient SUI/MUI. PV, surgical time, and no early apical release technique were factors associated with higher odds of persistent SUI/MUI.

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Holmium laser with MOSES technology (MoLEP) vs Thulium fiber laser enucleation of the prostate (ThuFLEP) in a real-world setting. Mid-term outcomes from a multicenter propensity score analysis

et al. 2023

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Incidence and risk factors for postoperative urinary incontinence after various prostate enucleation procedures: systemic review and meta-analysis of PubMed literature from 2000 to 2021

Cited by 15 publications

References 77 publications

Influence of urethral mucosa preservation of prostatic apex during monopolar transurethral resection of the prostate on postoperative functional outcomes: A retrospective comparative study

Influence of urethral mucosa preservation of prostatic apex during monopolar transurethral resection of the prostate on postoperative functional outcomes: A retrospective comparative study

Incidence of urinary incontinence following endoscopic laser enucleation of the prostate by en-bloc and non-en-bloc techniques: a multicenter, real-world experience of 5068 patients

Holmium laser with MOSES technology (MoLEP) vs Thulium fiber laser enucleation of the prostate (ThuFLEP) in a real-world setting. Mid-term outcomes from a multicenter propensity score analysis

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