Incidence and predictors of urinary incontinence rates post-holmium laser enucleation of prostate

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms Pub Date : 2023-06-27 DOI:10.1111/luts.12494

Mohamed Elsaqa, Yu Zhang, Harry Papaconstantinou, Marawan M. El Tayeb

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引用次数: 0

Abstract

Introduction

One of the main adverse outcomes following Holmium laser enucleation of the prostate (HoLEP) is the development of transient de novo urinary incontinence (UI). We aimed to evaluate the correlation of multiple risk factors to UI rates post-HoLEP.

Methods

A review of prospectively maintained 7 year database for HoLEP patients in a single center was performed. UI data at 6 week, 3 month, and 1 year follow-up intervals were assessed with bivariate and multivariate analysis of multiple potential risk factors.

Results

The study included 666 patients with median (IQR) age of 72 (66–78) years old and median (IQR) preoperative prostate volume of 89 (68–126) gm. UI was seen in 287 (43%), 100 (15%) and 26 (5.8%) at 6 week, 3 month, and 1 year follow up occasions respectively. At 6 weeks follow up, UI type was stress, urge and mixed in 121 (18.16%), 118 (17.72) and 48 (7.21%) patients respectively. Using a multivariate regression analysis, obesity and pre-operative UI were associated with postoperative UI rate at both 6 week (p = .0065, .031) and 3 month (p = .0261, .044) follow up encounters respectively. Also, larger specimen weight was another predictor for 6 week UI (p = .0399) while higher frailty score was a predictor for UI at 3 month occasion (p = .041).

Conclusion

Patients with preoperative UI, obesity, frailty, and large prostate volume are at higher risk of short-term UI post-HoLEP up to 3 months. Patients with one or more of these risk factors should be counseled regarding the higher risk of UI.

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钬激光前列腺摘除术后尿失禁发生率及预测因素

钬激光前列腺摘除(HoLEP)后的主要不良后果之一是一过性尿失禁(UI)的发展。我们的目的是评估多种危险因素与holep后UI率的相关性。方法对单中心HoLEP患者7年前瞻性数据库进行回顾性分析。随访6周、3个月和1年的UI数据通过多重潜在危险因素的双因素和多因素分析进行评估。结果666例患者中位(IQR)年龄为72(66 ~ 78)岁，术前前列腺体积中位(IQR)为89 (68 ~ 126)gm。随访6周、3个月和1年分别有287例(43%)、100例(15%)和26例(5.8%)出现尿潴留。随访6周时，尿失联类型分别为应激型、急迫型和混合型121例(18.16%)、118例(17.72)和48例(7.21%)。通过多因素回归分析，肥胖和术前尿失速与术后6周尿失速率相关(p =。0065, 0.031)和3个月(p =。0261, 0.044)分别进行后续接触。此外，较大的标本重量是6周UI的另一个预测因素(p = 0.099)，而较高的虚弱评分是3个月UI的预测因素(p = 0.041)。结论术前尿失禁、肥胖、虚弱、前列腺体积大的患者在holep术后3个月内发生短期尿失禁的风险较高。有一种或多种危险因素的患者应被告知患尿失禁的风险较高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

LUTS: Lower Urinary Tract Symptoms UROLOGY & NEPHROLOGY-

CiteScore

3.00

自引率

7.70%

发文量

审稿时长

>12 weeks

期刊介绍： LUTS is designed for the timely communication of peer-reviewed studies which provides new clinical and basic science information to physicians and researchers in the field of neurourology, urodynamics and urogynecology. Contributions are reviewed and selected by a group of distinguished referees from around the world, some of whom constitute the journal''s Editorial Board. The journal covers both basic and clinical research on lower urinary tract dysfunctions (LUTD), such as overactive bladder (OAB), detrusor underactivity, benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO), urinary incontinence, pelvic organ prolapse (POP), painful bladder syndrome (PBS), as well as on other relevant conditions. Case reports are published only if new findings are provided. LUTS is an official journal of the Japanese Continence Society, the Korean Continence Society, and the Taiwanese Continence Society. Submission of papers from all countries are welcome. LUTS has been accepted into Science Citation Index Expanded (SCIE) with a 2011 Impact Factor.