Document Type
Article
Publication Date
7-1-2020
Abstract
PURPOSE: To identify incidence and predictors of stress urinary incontinence (SUI) following Holmium laser enucleation of the prostate (HoLEP).
MATERIALS AND METHODS: We performed a retrospective review of 589 HoLEP patients from 2012-2018. Patients were assessed at pre-operative and post-operative visits. Univariate and multivariate regression analyses were performed to identify predictors of SUI.
RESULTS: 52/589 patients (8.8%) developed transient SUI, while 9/589 (1.5%) developed long-term SUI. tSUI resolved for 46 patients (88.5%) within the first six weeks and in 6 patients (11.5%) between 6 weeks to 3 months. Long-term SUI patients required intervention, achieving continence at 16.4 months on average, 44 men (70.9%) with incontinence were catheter dependent preoperatively. Mean prostatic volume was 148.7mL in tSUI patients, 111.6mL in long-term SUI, and 87.9mL in others (p < 0.0001). On univariate analysis, laser energy used (p < 0.0001), laser "on" time (p=0.0204), resected prostate weight (p < 0.0001), overall International Prostate Symptom Score (IPSS) (p=0.0005), and IPSS QOL (p=0.02) were associated with SUI. On multivariate analysis, resected prostate weight was predictive of any SUI and tSUI, with no risk factors identified for long-term SUI.
CONCLUSION: Post-HoLEP SUI occurs in ~10% of patients, with 1.5% continuing beyond six months. Most patients with tSUI recover within the first six weeks. Prostate size >100g and catheter dependency are associated with increased risk tSUI. Larger prostate volume is an independent predictor of any SUI, and tSUI.
Recommended Citation
Das, Akhil K; Teplitsky, Seth; Perez, Tomy; Guo, Jenny; Leong, Joon Yau; and Shenot, Patrick J, "Stress Urinary Incontinence post-Holmium Laser Enucleation of the Prostate: a Single-Surgeon Experience." (2020). Department of Urology Faculty Papers. Paper 57.
https://jdc.jefferson.edu/urologyfp/57
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
PubMed ID
32374125
Language
English
Comments
This article is the final published version from the International Brazilian Journal of Urology, Volume 46, Issue 4, Jul-Aug 2020, pages 624-631.
The published version of this article can be found at https://doi.org/10.1590/S1677-5538.IBJU.2019.0411.
Copyright Das et al.