Patient satisfaction after holmium laser enucleation of the prostate (HoLEP): A prospective cohort study

Lee, Young Ju; Oh, Soram; Kim, Sung-Han; Oh, Seung‐June

doi:10.1371/journal.pone.0182230

Cited by 25 publications

(35 citation statements)

References 33 publications

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“…As expected, SUI had a substantial negative impact on quality of life. This result is in line with previous reports showing the quality of life impact that incontinence can have on patients (26).…”

Section: Discussionsupporting

confidence: 93%

Stress Urinary Incontinence post-Holmium Laser Enucleation of the Prostate: a Single-Surgeon Experience

et al. 2020

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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.

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Section: Discussionsupporting

confidence: 93%

Stress Urinary Incontinence post-Holmium Laser Enucleation of the Prostate: a Single-Surgeon Experience

et al. 2020

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“…Lee et al . showed that a higher IPSS voiding score and higher QOL score were found after HoLEP . Woo et al .…”

Section: Factors Influencing Improvement Of Uroflowmetry After Holep mentioning

confidence: 97%

“…5 Lee et al showed that a higher IPSS voiding score and higher QOL score were found after HoLEP. 6 Woo et al stated the weight of the resected prostate contributed to improving postoperative Q max and post-void residual urine volume. 7 Mu et al reported that the operation for BPH >70 mL improved the functional outcome.…”

mentioning

confidence: 99%

Predictive factors of improvement for voiding symptoms after holmium laser enucleation of the prostate

Yamamichi¹,

Shigemura

Kitagawa

et al. 2018

Int J of Urology

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“…First, a newly developed exercise method can be provided to reinforce hip extensor muscle in patients with incontinence after radical prostatectomy. Furthermore, a new exercise method can be adopted to treat stress urinary incontinence in women and incontinence in men after transurethral prostatectomy such as holmium laser enucleation of the prostate [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of Progressive Resistance Training on Post-Surgery Incontinence in Men with Prostate Cancer

Park

Yoon

Yoo

et al. 2018

JCM

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We evaluated the efficacy of progressive resistance training of the pelvic floor muscle for post-prostatectomy incontinence. In this prospective study, 59 patients who underwent radical prostatectomy were evaluated preoperatively. Continence was sequentially assessed within 2 weeks postoperatively, and an exercise regimen was initiated at 6- and 12-weeks. The primary outcome was continent status and the secondary outcome was changes in muscle strength and endurance after the exercise intervention. Continence was defined as no urine loss in a 1h pad test. A total of 59 patients participated in this study. Six patients dropped out of the study because of non-compliance and orthopedic problems. Of the remaining 53 patients, 31 (58.5%) achieved pad-free continence at 12 weeks postoperatively. The patients were divided into two groups based on their continence status, and no statistically significant difference was observed in age, body mass index, prostate volume, prostate-specific antigen, pathological Gleason score sum, and pathological T stage. Meanwhile, preoperative maximal urethral closure pressure and change in hip extensor muscle strength and endurance during the 12-week exercise program were significantly higher in the continent group. In multivariate analysis, change in hip extensor muscle strength was the only significant parameter predicting achievement of continence status (Odds ratio, 1.039; p = 0.045). The changes in hip extensor muscle strength in the current exercise program was an independent predictor of continence status after radical prostatectomy. A large-scale prospective study on the relationship between extensor muscle strength and urinary incontinence should be explored in future.

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Patient satisfaction after holmium laser enucleation of the prostate (HoLEP): A prospective cohort study

Cited by 25 publications

References 33 publications

Stress Urinary Incontinence post-Holmium Laser Enucleation of the Prostate: a Single-Surgeon Experience

Stress Urinary Incontinence post-Holmium Laser Enucleation of the Prostate: a Single-Surgeon Experience

Predictive factors of improvement for voiding symptoms after holmium laser enucleation of the prostate

Effects of Progressive Resistance Training on Post-Surgery Incontinence in Men with Prostate Cancer

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