Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jul-Aug;42(4):740-6.
doi: 10.1590/S1677-5538.IBJU.2015.0477.

Predictive risk factors of postoperative urinary incontinence following holmium laser enucleation of the prostate during the initial learning period

Shuichiro Kobayashi  1 , Masataka Yano  1 , Takayuki Nakayama  1 , Satoshi Kitahara  1
Affiliations

Predictive risk factors of postoperative urinary incontinence following holmium laser enucleation of the prostate during the initial learning period

Shuichiro Kobayashi et al. Int Braz J Urol. 2016 Jul-Aug.

Abstract

Purpose: To determine the predictive factors for postoperative urinary incontinence (UI) following holmium laser enucleation of the prostate (HoLEP) during the initial learning period.

Patients and methods: We evaluated 127 patients with benign prostatic hyperplasia who underwent HoLEP between January 2011 and December 2013. We recorded clinical variables, including blood loss, serum prostate-specific antigen levels, and the presence or absence of UI. Blood loss was estimated as a decline in postoperative hemoglobina levels. The predictive factors for postoperative UI were determined using a multivariable logistic regression analysis.

Results: Postoperative UI occurred in 31 patients (24.4%), but it cured in 29 patients (93.5%) after a mean duration of 12 weeks. Enucleation time >100 min (p=0.043) and blood loss >2.5g/dL (p=0.032) were identified as significant and independent risk factors for postoperative UI.

Conclusions: Longer enucleation time and increased blood loss were independent predictors of postoperative UI in patients who underwent HoLEP during the initial learning period. Surgeons in training should take care to perform speedy enucleation maneuver with hemostasis.

Keywords: Blood Loss, Surgical; Prostatic Hyperplasia; Urinary Incontinence.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None declared.

References

    1. Gilling PJ, Cass CB, Cresswell MD, Fraundorfer MR. Holmium laser resection of the prostate: preliminary results of a new method for the treatment of benign prostatic hyperplasia. Urology. 1996;47:48–51. - PubMed
    1. Krambeck AE, Handa SE, Lingeman JE. Experience with more than 1,000 holmium laser prostate enucleations for benign prostatic hyperplasia. J Urol. 2010;183:1105–1109. - PubMed
    1. Shah HN, Mahajan AP, Hegde SS, Bansal MB. Peri-operative complications of holmium laser enucleation of the prostate: experience in the first 280 patients, and a review of literature. BJU Int. 2007;100:94–101. - PubMed
    1. Montorsi F, Naspro R, Salonia A, Suardi N, Briganti A, Zanoni M, et al. Holmium laser enucleation versus transurethral resection of the prostate: results from a 2-center, prospective, randomized trial in patients with obstructive benign prostatic hyperplasia. J Urol. 2004;172:1926–1929. - PubMed
    1. Tan AH, Gilling PJ, Kennett KM, Frampton C, Westenberg AM, Fraundorfer MR. A randomized trial comparing holmium laser enucleation of the prostate with transurethral resection of the prostate for the treatment of bladder outlet obstruction secondary to benign prostatic hyperplasia in large glands (40 to 200 grams) J Urol. 2003;170:1270–1274. - PubMed