Predictors of Postoperative Urinary Incontinence After Holmium Laser Enucleation of the Prostate: 12 Months Follow-Up

Cornwell, Laura B.; Smith, Garrett; Paonessa, Jessica E.

doi:10.1016/j.urology.2018.11.032

Cited by 12 publications

(4 citation statements)

References 17 publications

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“…In the present study, based on univariate and multivariate regression analysis results, we have proved that resectoscope size is an independent risk factor for TUL at 4 weeks after HoLEP. Previous research indicated that variables such as age, prostate size, diabetes, catheterization and operation time, BMI, and surgeon experience may be the risk factors for TUL in the early period after HoLEP 7,10,11 . However, in this study, other variables except resectoscope size were not found to be independent risk factors in the multiple regression analysis model.…”

Section: Discussioncontrasting

confidence: 80%

Does the use of a small‐size resectoscope during enucleation prevent transient urinary leakage and urethral stricture following holmium laser enucleation of the prostate?

İbiş

Tokatlı

2021

LUTS

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Objective To investigate the effect of the use of a small‐size resectoscope for enucleation during holmium laser enucleation of the prostate (HoLEP) on the prevention of transient urinary leakage (TUL) and urethral stricture (US). Methods One hundred patients were included in a retrospective single‐center study from January 2019 to December 2020. The patients were divided into two groups according to the resectoscope size which was used for enucleation (22F in group A [n = 40] and 26F in group B [n = 60]). Patients were evaluated at 4, 12, and 24 weeks postoperatively for TUL and US. Univariate and multivariate regression analyses were implemented to assess the variables which are associated with TUL at 4 weeks. Results Baseline characteristics and perioperative data were observed to be well balanced between groups. A statistically significant higher occurrence of TUL was detected at 4 weeks in group B compared to group A (P = .018). Higher improvement in International Prostate Symptom Score (IPSS) and quality of life (QoL) was observed in group A at 4 and 12 weeks postoperatively. On univariate analysis, resectoscope size, specimen weight, and body mass index were significant predictive factors for TUL at 4 weeks. Multivariate analysis illustrated that the resectoscope size was independently associated with TUL at 4 weeks after HoLEP (odds ratio = 3.1 [1.02‐9.38]). One patient in group A (2.5%) and two patients in group B (5%) demonstrated US (P = .648). Conclusion Enucleation with a 22F resectoscope provides better QoL and IPSS by reducing TUL rates in the early postoperative period.

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Section: Discussioncontrasting

confidence: 80%

Does the use of a small‐size resectoscope during enucleation prevent transient urinary leakage and urethral stricture following holmium laser enucleation of the prostate?

İbiş

Tokatlı

2021

LUTS

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“…It has been reported that approximately 16.6–29.4% of patients suffered from postoperative urinary incontinence within 6 months after HoLEP, but only 0–3.3% of patients could not fully recover their continence at 12 months [ 24 ]. Regarding the complications reported in this MA, similar incontinence rates were noted among the three included studies.…”

Section: Discussionmentioning

confidence: 99%

Does power setting impact surgical outcomes of holmium laser enucleation of the prostate? A systematic review and meta-analysis

Pirola

Castellani

Maggi

et al. 2022

Cent european J Urol

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Introduction The aim of this article was to enumerate the differences in immediate and postoperative outcomes for holmium laser enucleation of the prostate (HoLEP) performed with low-power (LP) or high-power (HP) laser settings through a systematic review of comparative studies. Material and methods We performed a systematic literature review using MEDLINE, EMBASE, and Cochrane Central Controlled Register of Trials. Potential clinical differences among LP and HP HoLEP were determined using the PICOS (Patient Intervention Comparison Outcome Study type) model, where outcomes were surgical time, operative efficiency, postoperative catheterization time, length of hospital stay, blood transfusion, incontinence rate, maximum urinary flow rate (QMax) and International Prostatic Symptom score (IPSS). Retrospective, prospective nonrandomized, randomized studies, and meeting abstracts were considered. Results A total of five studies were included for meta-analysis. No significant differences between LP and HP HoLEP were evidenced in terms of intraoperative variables (surgical time, surgical efficiency); postoperative outcomes (length of stay, length of catheterization); postoperative complications; functional results (IPSS; Qmax). Urinary incontinence rate did not differ between the two groups (OR 0.95, 95% CI 0.362.47, p = 0.91). Conclusions The study shows equal outcomes in outcomes from HoLEP performed with LP or HP energy settings. Even if further comparative studies are still needed to increase the level of evidence, those results encourage a further clinical adoption of LP HoLEP.

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“…It was reported that approximately 16.6%–29.4% of patients suffered from post‐operative UI within 6 months after HoLEP, but only 0%–3.3% of patients could not recover automatically at 12 months (Cornwell, Smith, & Paonessa, ). The incidence of UI after BipoLEP was 6.8%, among which 91.3% patients recovered 3 months after surgery and 97.5% patients recovered 6 months after surgery (Xu et al, ).…”

Section: Evidence Synthesismentioning

confidence: 99%

“…Early post‐operative training of pelvic floor muscle function might also contribute to improve the symptoms of UI. Whether anticholinergic drugs or β‐agonists could improve the symptoms of urinary incontinence was ambiguous (Cornwell et al, ).…”

Section: Evidence Synthesismentioning

confidence: 99%

Complications of anatomical endoscopic enucleation of the prostate

Wei

et al. 2020

Andrologia

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Transurethral resection of the prostate (TURP) remains the 'gold standard' for surgical treatment of benign prostatic obstruction (BPO). Recently, anatomical endoscopic enucleation of the prostate (AEEP) using holmium laser, thulium laser and plasma, etc., is extensively applied in clinical practice. However, perioperative complications of AEEP are inevitable in spite of lower incidence compared with TURP. This study reviewed the literature related to the aetiology, prevention and treatment of common complications of AEEP, which would contribute to the diagnosis and treatment of BPO.

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Predictors of Postoperative Urinary Incontinence After Holmium Laser Enucleation of the Prostate: 12 Months Follow-Up

Cited by 12 publications

References 17 publications

Does the use of a small‐size resectoscope during enucleation prevent transient urinary leakage and urethral stricture following holmium laser enucleation of the prostate?

Does the use of a small‐size resectoscope during enucleation prevent transient urinary leakage and urethral stricture following holmium laser enucleation of the prostate?

Does power setting impact surgical outcomes of holmium laser enucleation of the prostate? A systematic review and meta-analysis

Complications of anatomical endoscopic enucleation of the prostate

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