Predictive factors of urinary incontinence after holmium laser enucleation of the prostate: a multicentric evaluation

Houssin, V.; Olivier, Jonathan; Brenier, Martin; Piérache, Adeline; Laniado, Marc; Mouton, M.; Théveniaud, P.; Baumert, H.; Mallet, R.; Marquette, T.; Villers, Arnauld; Robert, G.; Rizk, J.

doi:10.1007/s00345-020-03169-0

Cited by 43 publications

(28 citation statements)

References 23 publications

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“…These results con rm those of Nam et al [7] who reported, in a retrospective series of 391 patients, a signi cantly higher rate of transient SUI in patients over 65 years old. In another retrospective and multicentric series of 2346 patients, increasing age and elevated BMI were also signi cantly associated with urinary incontinence [17]. Other demographic risk factors such as a history of diabetes mellitus and a pre-operative prostate volume greater than 81g have also been reported [17] but were not found in our study.…”

Section: Discussioncontrasting

confidence: 49%

“…In another retrospective and multicentric series of 2346 patients, increasing age and elevated BMI were also signi cantly associated with urinary incontinence [17]. Other demographic risk factors such as a history of diabetes mellitus and a pre-operative prostate volume greater than 81g have also been reported [17] but were not found in our study. Intrinsic sphincter insu ciency in elderly, overweight and diabetic patients could favour the occurrence of transient SUI after endoscopic enucleation [18].…”

Section: Discussioncontrasting

confidence: 49%

“…Elmansy et al showed that a decrease in PSA level greater than 84%, re ecting the amount of removed prostate tissue, was associated with a higher risk of stress urinary incontinence [19]. Similarly, enucleation weight have been considered as an independent intraoperative predictive factor of urinary incontinence at 3 and 6 months [17].…”

Section: Discussionmentioning

confidence: 99%

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Stress Urinary Incontinence After Holmium Laser Enucleation of Prostate: Incidence and Risk Factors

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et al. 2021

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Objectives: To evaluate the incidence and the risk factors of stress urinary incontinence (SUI) during the first year after HoLEP.Patients and Methods: This study presents a monocentric and retrospective study including 155 patients who underwent HoLEP for benign prostatic hyperplasia. The surgeries were performed by 2 expert surgeons. The continence was evaluated at 1, 3, 6 and 12 months. The predictive factors of SUI were analysed by logistic regression.Results:The SUI rate at 1, 3 and 6 months was 11.3%, 10.7% and 4.1% respectively. SUI remained present in 4 patients (2.6%) at 12 months. The mean ICIQ-SF scores in patients with SUI were 10.3±6.09 and 8±4.24 at 1 and 12 months respectively (p <0.05). BMI>30 (OR, 4.69; 95% CI, 1.51–14.52; p=0.007) and patients over 70 years old (OR, 16.23; 95% CI, 1.96–134.09; p=0.010) were identified as independent risk factors for SUI at 1 and 3 months respectively.Conclusion: SUI after HoLEP is transitory in most cases. It is favoured by a high BMI and an age over 70. These criteria should be considered before choosing the operative technique and preventive measures must be taken in high-risk patients.

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Section: Discussioncontrasting

confidence: 49%

Section: Discussioncontrasting

confidence: 49%

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Stress Urinary Incontinence After Holmium Laser Enucleation of Prostate: Incidence and Risk Factors

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et al. 2021

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“…Houssin et al, in their retrospective multicenter study of the HoLEP procedure, stated that surgeon's experience is the main predictive factor of early SUI. 20 We reported one case of capsular perforation and one case of morcellation injury, and they were both in the BPEP group and were managed conservatively by increasing the catheter duration from 7 to 10 days. Both techniques showed adequate hemostasis with no hemoglobin drop, and no surgery was aborted or converted to another type of surgery.…”

Section: Discussionmentioning

confidence: 91%

“…This was avoided in the present study by using a low‐energy HoLEP and early mucosal separation. Houssin et al ., in their retrospective multicenter study of the HoLEP procedure, stated that surgeon’s experience is the main predictive factor of early SUI 20 …”

Section: Discussionmentioning

confidence: 99%

Holmium laser enucleation of the prostate versus bipolar transurethral enucleation of the prostate in management of benign prostatic hyperplasia: A randomized controlled trial

et al. 2020

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Objective To evaluate the safety, efficacy and cost‐effectiveness of holmium enucleation of the prostate and bipolar transurethral enucleation of the prostate. Methods In our randomized controlled trial, 120 patients were allocated into two equal groups representing holmium enucleation of the prostate and bipolar enucleation of the prostate. Operative parameters were recorded according to operative, enucleation and resection time in addition to the intraoperative complications. Patients were followed up at 1, 3 and 12 months postoperative to assess the prostate size, post‐voiding residual urine, International Prostate Symptom Score, peak urine flow rate and quality of life, and compared with the preoperative parameters. Cost analysis was evaluated for both procedures. Results We evaluated 107 patients who finished our follow up and their data were analyzed. The prostate size was 135.2 ± 34.8 mL and 125 ± 26.9 mL for holmium enucleation of the prostate and bipolar enucleation of the prostate, respectively. Holmium enucleation of the prostate was associated with a shorter operative time of 83.43 ± 6.92 min compared with 94.7 ± 12.2 min in bipolar enucleation of the prostate groups. Holmium enucleation of the prostate was associated with an earlier catheter removal time and shorter hospital stay compared with bipolar enucleation of the prostate. Postoperative International Prostate Symptom Score, quality of life, post‐voiding residual urine, peak urine flow rate, prostate‐specific antigen and prostate volume reduction were comparable between both groups, and they both showed statistically significant improvement compared with their preoperative parameters. In the cost analysis, holmium enucleation of the prostate was more cost‐effective than bipolar enucleation of the prostate. Conclusion Both holmium enucleation of the prostate and bipolar enucleation of the prostate are safe and effective in the surgical management of large prostatic adenomas. Holmium enucleation of the prostate has a shorter operative time and hospital stay with earlier catheter removal time, and is more cost‐effective than bipolar enucleation of the prostate.

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Predictive factors of urinary incontinence after holmium laser enucleation of the prostate: a multicentric evaluation

Cited by 43 publications

References 23 publications

Stress Urinary Incontinence After Holmium Laser Enucleation of Prostate: Incidence and Risk Factors

Stress Urinary Incontinence After Holmium Laser Enucleation of Prostate: Incidence and Risk Factors

Holmium laser enucleation of the prostate versus bipolar transurethral enucleation of the prostate in management of benign prostatic hyperplasia: A randomized controlled trial

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