Predictors of Failed Same-Day Catheter Removal After Holmium Laser Enucleation of the Prostate

Cooley, Lauren Folgosa; Assmus, Mark; Ganesh, Meera; Lee, Matthew; Helon, Jessica; Krambeck, Amy E.

doi:10.1016/j.urology.2022.07.047

Cited by 5 publications

(2 citation statements)

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“…A longer lasing time could in fact hardly justify a greater risk of AUR, but may rather reflect a higher attention in hemostasis, since patients needing catheter replacement showed a significantly higher use of AC/AP at baseline. The hypothetical risks carried by the ongoing AC/AP therapy during HoLEP was already confirmed by different previous studies (6,19,20), although it should be highlighted that the rate of postoperative bleeding even in case of AC/AP therapy is anyhow quite acceptable and makes Ho-LEP an excellent technique to treat also complex patients. In this regard, our group recently published a paper demonstrating that, in experienced hands, HoLEP represents an effective option for the treatment of BPH also for high comorbid patients (5).…”

Section: Discussionmentioning

confidence: 77%

“…Despite the good perioperative profile, some patients still experience postoperative acute urinary retention (AUR) after catheter removal, thus leading to prolonged hospitalization, longer indwelling catheter time and higher readmission rates. However, to date only little evidence is available on perioperative variables associated with AUR following HoLEP ( 6 , 7 ).…”

Section: Introductionmentioning

confidence: 99%

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Predictors of early catheter replacement after HoLEP. Results from a high-volume laser center

et al. 2023

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Introduction: The aim of the study was to investigate clinical and surgical factors associated with early catheter replacement in patients treated with Holmium Laser Enucleation of the Prostate (HoLEP). Materials and Methods: Data of patients treated with HoLEP at our Institution by a single surgeon from March 2017 to January 2021 were collected. Preoperative variables, including non-invasive uroflowmetry and abdominal ultrasonography (US), were recorded. Bladder wall modifications (BWM) at preoperative US were defined as the presence of single or multiple bladder diverticula or bladder wall thickening ≥5 mm. Clinical symptoms were assessed using validated questionnaires. Only events occurred within the first week after catheter removal were considered. Results: Overall, 305 patients were included, of which 46 (15.1%) experienced early catheter replacement. Maintenance of anticoagulants/antiplatelets (AC/AP) therapy at surgery (p=0.001), indwelling urinary catheter (p=0.02) and the presence of BWM (p=0.001) were more frequently reported in patients needing postoperative re-catheterization. Intraoperative complications (p=0.02) and median lasing time (p=0.02) were significantly higher in this group. At univariate analysis, indwelling urinary catheter (p=0.02), BWM (p=0.01), ongoing AC/AP therapy (p=0.01) and intraoperative complications (p=0.01) were significantly associated with early catheter replacement. At multivariate analysis, indwelling urinary catheter (OR: 1.28; p=0.02), BWM (OR: 2.87; p=0.001), and AC/AP therapy (OR: 2.21; p=0.01) were confirmed as independent predictors of catheter replacement. Conclusions: In our experience the presence of indwelling urinary catheter before surgery, BWM and the maintenance of AC/AP therapy were shown to be independent predictors of early catheter replacement after HoLEP.

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Section: Discussionmentioning

confidence: 77%

Section: Introductionmentioning

confidence: 99%