MP59-18 THE INCIDENCE OF CLINICALLY SIGNIFICANT PROSTATE CANCER AFTER HoLEP

Abstract

INTRODUCTION AND OBJECTIVE: Rates of transient postoperative urinary incontinence (UI) after holmium laser enucleation of the prostate (HoLEP) are quite variable in the existing literature. Classically, post-HoLEP UI has been found to be associated with surgeon experience and surgical technique. Patients experiencing UI are typically reassured about the expected continence recovery but the timeline of this recovery remains poorly understood. We sought to evaluate whether any patient-related factors played a role in the speed of post-HoLEP continence recovery.METHODS: We performed a prospective observational cohort study of patients undergoing HoLEP with a single surgeon from 2020 to 2021. Demographic and clinical variables were collected for analysis. Patients were followed post-operatively until they regained urinary continence. Univariate and multivariable logistic regression analyses were performed to identify predictors of early (<1 month) versus delayed (>1 month) continence recovery after HoLEP.RESULTS: A total of 171 patients were included in the analysis, 35% of whom took longer than one month to regain continence. On univariate analysis, diabetes mellitus, prostate size, length of surgery, and degree of post-operative hematuria were all associated with delayed continence recovery. On multivariable logistic regression, patients with diabetes were 3.6x more likely to experience delayed continence recovery. Patients with worse post-operative hematuria were also significantly more likely to remain incontinent for a longer period of time (OR 14, CONCLUSIONS: Surgeon experience and surgical technique may not be the only factors associated with post-operative urinary incontinence after HoLEP. Our findings indicate that patient-related factors such as diabetes mellitus can delay continence recovery as well. This understanding can inform providers' counseling practices when setting patients' expectations when undergoing HoLEP.