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World Journal of Urology
Erschienen in:

26.03.2020 | Original Article

Predictive factors of urinary incontinence after holmium laser enucleation of the prostate: a multicentric evaluation

verfasst von: Vianney Houssin, Jonathan Olivier, Martin Brenier, Adeline Pierache, Marc Laniado, Martin Mouton, Pierre Etienne Theveniaud, Hervé Baumert, Richard Mallet, Thibault Marquette, Arnauld Villers, Grégoire Robert, Jerome Rizk

Erschienen in: World Journal of Urology | Ausgabe 1/2021

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Abstract

Objective

To evaluate predictive factors of urinary incontinence (UI) after holmium laser enucleation of the prostate (HoLEP).

Methods

Patients (n = 2346) were included in a retrospective multicentric study from April 2012 to November 2017. Patients’ characteristics (age, BMI, percentage with diabetes), preoperative data (IPSS score, whole gland volume, urinary drainage), operative data (enucleation time, enucleation efficiency, tissue enucleated weight, total delivered energy) and postoperative data were recorded. Absence of UI was defined as no pads at 3 and 6 months. Surgeon experience was stratified in three categories: beginners (< 21 cases), intermediate (21–40 cases) and experienced (> 40 cases). Multivariate logistic regression analysis was performed.

Results

UI was observed in 14.5% of patients (340/2346) at 3 months (95%CI 13–16%) and in 4.2% (98/2346) at 6 months (95%CI 3–5%). On multivariate analysis at 3 months, increasing age (OR per SD = 1.3 [1.14–1.48]), elevated BMI (OR per SD = 1.23 [1.09–1.38]), preoperative urinary drainage (OR = 0.62 [0.45–0.85]), increasing enucleated tissue weight (OR per SD = 1.29 [1.16–1.45]) and experienced surgeon with at least 40 cases (OR = 0.56 [0.42–0.75]) were significantly associated with UI. At 6 months, increasing age (OR per SD = 1.25 [1.01–1.53]), elevated BMI (OR per SD = 1.25 [1.03–1.5]), increasing whole gland volume (OR per one SD log = 1.24 [1.01–1.53]) and diabetes disorder (OR = 1.7 [1.03–2.78]) were significantly associated with UI.

Conclusion

UI after HoLEP was observed in 14.5% of patients at 3 months and 4.2% at 6 months, with stress UI in half of the cases. Surgeon experience with at least 40 cases was the main predictive factor of 3 months UI after HoLEP and diabetes disorder of persistent UI at 6 months.
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Metadaten
Titel
Predictive factors of urinary incontinence after holmium laser enucleation of the prostate: a multicentric evaluation
verfasst von
Vianney Houssin
Jonathan Olivier
Martin Brenier
Adeline Pierache
Marc Laniado
Martin Mouton
Pierre Etienne Theveniaud
Hervé Baumert
Richard Mallet
Thibault Marquette
Arnauld Villers
Grégoire Robert
Jerome Rizk
Publikationsdatum
26.03.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
World Journal of Urology / Ausgabe 1/2021
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-020-03169-0

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