Abstract

Background and objective: To evaluate the incidence and the risk factors of stress urinary incontinence (SUI) during the first year following Holmium Laser Enucleation of the Prostate (HoLEP). Materials and methods: Our monocentric and retrospective study includes 155 patients who underwent HoLEP for benign prostatic hyperplasia. Surgeries were performed by 2 expert surgeons. The continence was evaluated before and after surgery at 1, 3, 6 and 12 months. The predictive factors of SUI were analysed using logistic regression.Results: The SUI rate at 1, 3, 6 and 12 months was respectively 7.3%, 8.1%, 3.4% and 2.7%. SUI remained present in 4 patients (2.6%) at 12 months. The mean International Consultation Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-SF) score for patients with SUI was respectively 11.69 ± 5.28, 8.70 ± 4.24, 1.81 ± 3.53 and 8 ± 4.24 at 1, 3, 6 and 12 months (p 30 (Odds Ratio (OR), 4.69; 95% Confidence Interval (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 respectively identified as independent risk factors for SUI at 1 and 3 months.Conclusions: 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.

Highlights

  • Transurethral resection of the prostate (TURP) and open prostatectomy (OP) still remain the “gold standard” surgical treatment for symptomatic benign prostatic hyperplasia (BPH) resistant to medical treatment [1, 2].Holmium laser enucleation of the prostate (HoLEP) has recently become an important alternative treatment modality to TURP and OP [3]

  • The aim of this study was to evaluate the incidence of stress urinary incontinence after Holmium Laser Enucleation of the Prostate (HoLEP) and identify relevant risk factors

  • A reusable 1000 μ laser fiber was inserted through a 24.5 Fr endoscope and the holmium generator was set to 100 W (2 J, 50 Hz)

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Summary

Introduction

Holmium laser enucleation of the prostate (HoLEP) has recently become an important alternative treatment modality to TURP and OP [3]. This endoscopic approach enables a complete excision of the adenoma whatever its volume. To evaluate the incidence and the risk factors of stress urinary incontinence (SUI) during the first year following Holmium Laser Enucleation of the Prostate (HoLEP). Body Mass Index (BMI) >30 (Odds Ratio (OR), 4.69; 95% Confidence Interval (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 respectively identified as independent risk factors for SUI at 1 and 3 months. These criteria should be considered before choosing the operative technique and preventive measures must be taken in high-risk patients

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