Predictive factors of urinary incontinence after holmium laser enucleation of the prostate: a multicentric evaluation
- 26 March 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in World Journal of Urology
- Vol. 39 (1), 143-148
- https://doi.org/10.1007/s00345-020-03169-0
Abstract
Objective To evaluate predictive factors of urinary incontinence (UI) after holmium laser enucleation of the prostate (HoLEP). Methods Patients (n = 2346) were included in a retrospective multicentric study from April 2012 to November 2017. Patients’ characteristics (age, BMI, percentage with diabetes), preoperative data (IPSS score, whole gland volume, urinary drainage), operative data (enucleation time, enucleation efficiency, tissue enucleated weight, total delivered energy) and postoperative data were recorded. Absence of UI was defined as no pads at 3 and 6 months. Surgeon experience was stratified in three categories: beginners (< 21 cases), intermediate (21–40 cases) and experienced (> 40 cases). Multivariate logistic regression analysis was performed. Results UI was observed in 14.5% of patients (340/2346) at 3 months (95%CI 13–16%) and in 4.2% (98/2346) at 6 months (95%CI 3–5%). On multivariate analysis at 3 months, increasing age (OR per SD = 1.3 [1.14–1.48]), elevated BMI (OR per SD = 1.23 [1.09–1.38]), preoperative urinary drainage (OR = 0.62 [0.45–0.85]), increasing enucleated tissue weight (OR per SD = 1.29 [1.16–1.45]) and experienced surgeon with at least 40 cases (OR = 0.56 [0.42–0.75]) were significantly associated with UI. At 6 months, increasing age (OR per SD = 1.25 [1.01–1.53]), elevated BMI (OR per SD = 1.25 [1.03–1.5]), increasing whole gland volume (OR per one SD log = 1.24 [1.01–1.53]) and diabetes disorder (OR = 1.7 [1.03–2.78]) were significantly associated with UI. Conclusion UI after HoLEP was observed in 14.5% of patients at 3 months and 4.2% at 6 months, with stress UI in half of the cases. Surgeon experience with at least 40 cases was the main predictive factor of 3 months UI after HoLEP and diabetes disorder of persistent UI at 6 months.Keywords
This publication has 22 references indexed in Scilit:
- Does Surgeon Experience Affect Operative Time, Adverse Events and Continence Outcomes in Holmium Laser Enucleation of the Prostate? A Review of More Than 1,000 CasesJournal of Urology, 2017
- Practical Index of Urinary Incontinence Following Holmium Laser Enucleation of the Prostate: A Case-Series Study of the 24-Hour Pad Test Immediately after Catheter RemovalUrologia Internationalis, 2016
- Multicentre prospective evaluation of the learning curve of holmium laser enucleation of the prostate (HoLEP)BJU International, 2015
- EAU Guidelines on the Assessment of Non-neurogenic Male Lower Urinary Tract Symptoms including Benign Prostatic ObstructionEuropean Urology, 2015
- A Systematic Review and Meta-analysis of Functional Outcomes and Complications Following Transurethral Procedures for Lower Urinary Tract Symptoms Resulting from Benign Prostatic Obstruction: An UpdateEuropean Urology, 2015
- Risk Factors for Transient Urinary Incontinence after Holmium Laser Enucleation of the ProstateThe World Journal of Men's Health, 2015
- Is There a Way to Predict Stress Urinary Incontinence After Holmium Laser Enucleation of the Prostate?Journal of Urology, 2011
- Comparison of Predictive Factors for Postoperative Incontinence of Holmium Laser Enucleation of the Prostate by the Surgeons’ Experience During Learning CurveInternational Neurourology Journal, 2006
- HOLMIUM LASER ENUCLEATION VERSUS TRANSURETHRAL RESECTION OF THE PROSTATE: RESULTS FROM A 2-CENTER, PROSPECTIVE, RANDOMIZED TRIAL IN PATIENTS WITH OBSTRUCTIVE BENIGN PROSTATIC HYPERPLASIAJournal of Urology, 2004
- The standardisation of terminology of lower urinary tract function: Report from the standardisation sub‐committee of the International Continence SocietyNeurourology and Urodynamics, 2002