Effect of Holmium Laser Enucleation of Prostate on Overactive Bladder Symptoms and Urodynamic Parameters: A Prospective Study

Kwon, Ohseong; Lee, Hahn Ey; Bae, Jun Ho; Oh, Jin Kyu; Oh, Seung‐June

doi:10.1016/j.urology.2013.10.037

Cited by 31 publications

(26 citation statements)

References 21 publications

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“…Kwon et al. reported that OAB symptoms and urodynamic parameters improved significantly after HoLEP surgery in short‐term follow‐up [8]. Additionally, Mitchell et al.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, by using a holmium laser to perform complete enucleation of the prostate, Holmium Laser Enucleation of the prostate (HoLEP) has replaced TURP as the current standard operation, which has been shown to be an effective and safe surgical treatment for benign prostatic obstruction without any size limitation [6]. HoLEP offers excellent short‐term results for men with both hypocontractile and a contractile bladder [7], and overactive bladder symptoms and urodynamic parameters were also reported to improve significantly after HoLEP surgery in a short‐term follow‐up study [8]. However, studies on the efficacy of HoLEP in comparison to preoperative urodynamic findings are scarce.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of holmium laser enucleation of the prostate (HoLEP) in men with bladder outlet obstruction (BOO) and non‐neurogenic bladder dysfunction

Pyun

Kang

et al. 2017

The Kaohsiung J of Med Scie

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We aimed to compare the short-term outcomes of men who had urodynamic evidence of detrusor underactivity (DU) or detrusor overactivity (DO) of a non-neurogenic etiology as well as bladder outlet obstruction (BOO) and who underwent Holmium Laser Enucleation of the prostate (HoLEP). A database of 322 patients who underwent HoLEP between 2010 and 2014 was analyzed. Patients were classified into three groups according to the results of a preoperative urodynamic study. Preoperative parameters such as International Prostate Symptom Score (IPSS), Quality of Life (QoL) index, IPSS grade, uroflowmetry were compared with postoperative parameters measured at 6 months. There were 138 patients with BOO-only and 89 patients with BOO and detrusor dysfunction including 56 with DO and 33 with DU. The degree of improvement in IPSS-total (BOO: 10.7, DO: 8.3, DU: 7.0; p = 0.023) was greater in the BOO-only group than in the DU group. There were more patients whose IPSS grade improved in the BOO-only group (71%) than in the detrusor dysfunction group (DO: 53.6% and DU: 45.5%). Postoperative IPSS-voiding (4.5 vs 7.0), and Qmax (18 vs 13.7) in the BOO-only group were significantly better than those in the DU group. Additionally, postoperative IPSS-storage (4.7 vs 6.7), and IPSS-total (9.1 vs 12.3) in the BOO-only group were significantly better than in the DO group (all p < 0.05). In conclusion, early surgical management for men with severe LUTS and associated BPH before secondary degeneration occurs may be beneficial for preserving detrusor function and yield better treatment outcomes.

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“…Kwon et al. reported that OAB symptoms and urodynamic parameters improved significantly after HoLEP surgery in short‐term follow‐up [8]. Additionally, Mitchell et al.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy of holmium laser enucleation of the prostate (HoLEP) in men with bladder outlet obstruction (BOO) and non‐neurogenic bladder dysfunction

Pyun

Kang

et al. 2017

The Kaohsiung J of Med Scie

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“…18 Therefore, TURP seems to have a significant therapeutic effect on DO caused by BPO. Recently, Kwon et al 21 reported the effect of HoLEP on OAB symptoms and urodynamic parameters in patients with benign prostatic hyperplasia. They demonstrated that the proportion of patients who showed involuntary detrusor contraction in urodynamics decreased significantly from 44.9% at baseline to 36.1% at 6-month follow-ups.…”

Section: Commentmentioning

confidence: 99%

Effect of Detrusor Overactivity on Functional Outcomes After Holmium Laser Enucleation of the Prostate in Patients With Benign Prostatic Obstruction

Jeong

Lee

Cho

et al. 2015

Urology

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“…It has also been reported that OAB symptoms and urodynamic parameters improved after the HoLEP surgery [9]. However, OAB symptoms can still remain in some patients even after appropriate surgical treatment and one study showed that urge incontinence lasted longer after the HoLEP than the TURP procedure [10].…”

Section: Introductionmentioning

confidence: 99%

Predictors of urgency improvement after Holmium laser enucleation of the prostate in men with benign prostatic hyperplasia

Hur

Kim

et al. 2016

Investig Clin Urol

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PurposeTo investigate the change in urinary urgency and predictors of urgency improvement after holmium laser enucleation of the prostate (HoLEP) in men with benign prostatic hyperplasia (BPH).Materials and MethodsWe retrospectively analyzed the medical records of patients who were treated with HoLEP for BPH and had preoperative urgency measuring ≥3 on a 5-point urinary sensation scale. Those with prostate cancer diagnosed prior to or after HoLEP, a history of other prostatic and/or urethral surgery, moderate to severe postoperative complications, and neurogenic causes were excluded. Patients who had improved urgency with antimuscarinic medication after HoLEP were excluded. We divided the patients into 2 groups based on urgency symptoms 3 months after HoLEP: improved and unimproved urgency. Improved urgency was defined as a reduction of 2 or more points on the 5-point urinary sensation scale. Preoperative clinical and urodynamic factors as well as perioperative factors were compared between groups.ResultsIn total, 139 patients were included in this study. Voiding parameters in all patients improved significantly after HoLEP. Seventy-one patients (51.1%) had improved urgency, while 68 (48.9%) did not show any improvement. A history of acute urinary retention (AUR) and postvoid residual were associated with postoperative urgency improvement in univariate analysis. In multivariate analysis, a history of AUR was an independent factor affecting urgency improvement.ConclusionsA preoperative history of AUR could influence the change in urgency after HoLEP surgery in patients with BPH.

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Effect of Holmium Laser Enucleation of Prostate on Overactive Bladder Symptoms and Urodynamic Parameters: A Prospective Study

Cited by 31 publications

References 21 publications

Efficacy of holmium laser enucleation of the prostate (HoLEP) in men with bladder outlet obstruction (BOO) and non‐neurogenic bladder dysfunction

Efficacy of holmium laser enucleation of the prostate (HoLEP) in men with bladder outlet obstruction (BOO) and non‐neurogenic bladder dysfunction

Effect of Detrusor Overactivity on Functional Outcomes After Holmium Laser Enucleation of the Prostate in Patients With Benign Prostatic Obstruction

Predictors of urgency improvement after Holmium laser enucleation of the prostate in men with benign prostatic hyperplasia

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