You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology I (MP01)1 Sep 2021MP01-04 DIFFERENCES IN SURGICAL TREATMENT OF DE NOVO URGE INCONTINENCE OCCURRING POST-HOLMIUM LASER ENUCLEATION OF THE PROSTATE Lucas Richards, Bristol Whiles, Diego Mazzotti, and Kerri Thurmon Lucas RichardsLucas Richards More articles by this author , Bristol WhilesBristol Whiles More articles by this author , Diego MazzottiDiego Mazzotti More articles by this author , and Kerri ThurmonKerri Thurmon More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001962.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Holmium laser enucleation of the prostate (HoLEP) is an effective option for patients with lower urinary tract symptoms secondary to benign prostate hyperplasia. Although HoLEP has well-established and durable outcomes, it carries a risk of iatrogenic urinary incontinence. Most patients with de novo urge incontinence (UI) experience transient symptoms with resolution rather quickly, but some patients have persistent incontinence. Due to its relative rarity, patient factors that increase the risk of post-HoLEP persistent UI requiring surgical treatment have not been examined. In this study, we identify management options for persistent UI after HoLEP and examine patient risk factors for the condition. Furthermore, we examine symptom response to three surgical treatment options for de novo UI post-HoLEP. METHODS: A retrospective study was performed to identify patients who underwent HoLEP at a single institution between 2016 and 2019. Patient demographics including age, BMI, race, smoking status, history of previous procedures, diabetes, erectile dysfunction, UTI, and pelvic floor physical therapy were evaluated. Prescriptions for alpha blockers, 5-alpha reductase inhibitors, anticholinergic agents, and beta-3 agonists were also identified. Bidirectional stepwise regression was performed using the history of a surgical treatment for UI as the outcome. These procedures include intravesical onabotulinumtoxinA (Botox) injection, peripheral tibial nerve stimulation (PTNS), or sacral neuromodulation (SNM). AUA symptom and quality of life scores were compared in patients with persistent UI that progressed to surgical treatment to those that did not. RESULTS: A total of 340 patients underwent HoLEP during the study period. We evaluated 28 possible risk factors for persistent UI requiring surgical management. Eight (2.4%) patients received one of the third line therapies, with 1 receiving PTNS, 6 receiving SNM alone, and 1 receiving both SNM and Botox. Our current model suggests that a history of UTI prior to HoLEP procedure increases the odds of developing the UI outcome by 36.98-fold; 95% CI [2.75, 496.90]; p=0.006. CONCLUSIONS: Although persistent UI after HoLEP is rare, its management and associated risk factors are important to understand. Prior UTI is associated with increased risk of post-HoLEP UI. These are preliminary results and future studies are needed to further investigate risk factors for persistent UI post-HoLEP as well as compare outcomes for management options. Source of Funding: Presenting author is a trainee supported by TL1TR002368 © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e2-e2 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lucas Richards More articles by this author Bristol Whiles More articles by this author Diego Mazzotti More articles by this author Kerri Thurmon More articles by this author Expand All Advertisement Loading ...