2105 STRESS URINARY INCONTINENCE FOLLOWING HOLMIUM LASER ENUCLEATION OF THE PROSTATE: IS THERE A WAY TO PREDICT?

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy and New Technology1 Apr 20112105 STRESS URINARY INCONTINENCE FOLLOWING HOLMIUM LASER ENUCLEATION OF THE PROSTATE: IS THERE A WAY TO PREDICT? Hazem Elmansy, Ahmed Kotb, and Mostafa Elhilali Hazem ElmansyHazem Elmansy Montreal, Canada More articles by this author , Ahmed KotbAhmed Kotb Montreal, Canada More articles by this author , and Mostafa ElhilaliMostafa Elhilali Montreal, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2301AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The aim of our study was to define the high risk patients to develop SUI, post holmium laser enucleation of the prostate. METHODS A retrospective analysis of 952 consecutive patients, managed by holmium laser enucleation of the prostate, over 10 years period, by a single surgeon, was done. Patients were divided into 2 groups; group (1) represents cases that didn't develop SUI postoperatively (905 patients) and (2) that developed SUI (47 patients). All preoperative, intraoperative and postoperative clinical variables were collected and correlated with the two studied groups. Statistical analysis was done using median, Mann Whitney test and Fisher Exact test. Multivariate analysis was done using General linear model. RESULTS The median age of the patients, pre and post operative PSA, prostate volume and operative time were 70 years, 4.3 ng/ml, 0.6 ng/ml, 81 grams and 96 minutes respectively. Patients' age, pre and postoperative PSA, preoperative medications, preoperative acute retention and the duration of postoperative catheter time were not factors predicting the occurrence of SUI postoperatively (p 0.09, 0.5, 0.06, 0.8, 0.5 and 0.5 respectively). Median prostate volume was 80 and 99.5 grams (p 0.01), operative time 95 and 110 minutes (p 0.01), percentage of reduction of PSA 83% and 91% (p 0.006), for groups (1) and (2) respectively. Presence of D.M was significantly associated with higher incidence of SUI (p 0.001). Using medians of the whole cohort, prostate volume >81 grams, operative time >96 minutes and reduction of PSA >84% were significantly associated with occurrence of SUI (p 0.02, 0.02 and 0.005 respectively). On multivariate analysis; prostate volume > 81 grams, presence of D.M and >84% reduction in PSA value were 3 independent factors significantly associated with SUI. CONCLUSIONS HoLEP results in SUI at a rate comparable with other surgical techniques for the treatment of BPH. The presence of DM, large prostate volume and a greater reduction in the postoperative PSA are independently associated with a higher rate for the development of SUI. Diabetic patients, especially those with large prostate volume should be encouraged to start Kegel exercises in the immediate postoperative period. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e841 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hazem Elmansy Montreal, Canada More articles by this author Ahmed Kotb Montreal, Canada More articles by this author Mostafa Elhilali Montreal, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...