Efficacy of holmium laser enucleation of the prostate (HoLEP) in men with bladder outlet obstruction (BOO) and non-neurogenic bladder dysfunction

We aimed to compare the short-term outcomes of men who had urodynamic evidence of detrusor underactivity (DU) or detrusor overactivity (DO) of a non-neurogenic etiology as well as bladder outlet obstruction (BOO) and who underwent Holmium Laser Enucleation of the prostate (HoLEP). A database of 322...

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Main Authors: Jong Hyun Pyun, Sung Gu Kang, Seok Ho Kang, Jun Cheon, Je Jong Kim, Jeong Gu Lee
Format: Article
Language:English
Published: Wiley 2017-09-01
Series:Kaohsiung Journal of Medical Sciences
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1607551X1630465X
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author Jong Hyun Pyun
Sung Gu Kang
Seok Ho Kang
Jun Cheon
Je Jong Kim
Jeong Gu Lee
author_facet Jong Hyun Pyun
Sung Gu Kang
Seok Ho Kang
Jun Cheon
Je Jong Kim
Jeong Gu Lee
author_sort Jong Hyun Pyun
collection DOAJ
description We aimed to compare the short-term outcomes of men who had urodynamic evidence of detrusor underactivity (DU) or detrusor overactivity (DO) of a non-neurogenic etiology as well as bladder outlet obstruction (BOO) and who underwent Holmium Laser Enucleation of the prostate (HoLEP). A database of 322 patients who underwent HoLEP between 2010 and 2014 was analyzed. Patients were classified into three groups according to the results of a preoperative urodynamic study. Preoperative parameters such as International Prostate Symptom Score (IPSS), Quality of Life (QoL) index, IPSS grade, uroflowmetry were compared with postoperative parameters measured at 6 months. There were 138 patients with BOO-only and 89 patients with BOO and detrusor dysfunction including 56 with DO and 33 with DU. The degree of improvement in IPSS-total (BOO: 10.7, DO: 8.3, DU: 7.0; p = 0.023) was greater in the BOO-only group than in the DU group. There were more patients whose IPSS grade improved in the BOO-only group (71%) than in the detrusor dysfunction group (DO: 53.6% and DU: 45.5%). Postoperative IPSS-voiding (4.5 vs 7.0), and Qmax (18 vs 13.7) in the BOO-only group were significantly better than those in the DU group. Additionally, postoperative IPSS-storage (4.7 vs 6.7), and IPSS-total (9.1 vs 12.3) in the BOO-only group were significantly better than in the DO group (all p < 0.05). In conclusion, early surgical management for men with severe LUTS and associated BPH before secondary degeneration occurs may be beneficial for preserving detrusor function and yield better treatment outcomes.
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spelling doaj.art-6fc14163b5564f9ea9df3a20556842682022-12-22T01:42:01ZengWileyKaohsiung Journal of Medical Sciences1607-551X2017-09-0133945846310.1016/j.kjms.2017.06.010Efficacy of holmium laser enucleation of the prostate (HoLEP) in men with bladder outlet obstruction (BOO) and non-neurogenic bladder dysfunctionJong Hyun PyunSung Gu KangSeok Ho KangJun CheonJe Jong KimJeong Gu LeeWe aimed to compare the short-term outcomes of men who had urodynamic evidence of detrusor underactivity (DU) or detrusor overactivity (DO) of a non-neurogenic etiology as well as bladder outlet obstruction (BOO) and who underwent Holmium Laser Enucleation of the prostate (HoLEP). A database of 322 patients who underwent HoLEP between 2010 and 2014 was analyzed. Patients were classified into three groups according to the results of a preoperative urodynamic study. Preoperative parameters such as International Prostate Symptom Score (IPSS), Quality of Life (QoL) index, IPSS grade, uroflowmetry were compared with postoperative parameters measured at 6 months. There were 138 patients with BOO-only and 89 patients with BOO and detrusor dysfunction including 56 with DO and 33 with DU. The degree of improvement in IPSS-total (BOO: 10.7, DO: 8.3, DU: 7.0; p = 0.023) was greater in the BOO-only group than in the DU group. There were more patients whose IPSS grade improved in the BOO-only group (71%) than in the detrusor dysfunction group (DO: 53.6% and DU: 45.5%). Postoperative IPSS-voiding (4.5 vs 7.0), and Qmax (18 vs 13.7) in the BOO-only group were significantly better than those in the DU group. Additionally, postoperative IPSS-storage (4.7 vs 6.7), and IPSS-total (9.1 vs 12.3) in the BOO-only group were significantly better than in the DO group (all p < 0.05). In conclusion, early surgical management for men with severe LUTS and associated BPH before secondary degeneration occurs may be beneficial for preserving detrusor function and yield better treatment outcomes.http://www.sciencedirect.com/science/article/pii/S1607551X1630465XBladder outlet obstructionProstatic hyperplasiaTransurethral resection of prostate
spellingShingle Jong Hyun Pyun
Sung Gu Kang
Seok Ho Kang
Jun Cheon
Je Jong Kim
Jeong Gu Lee
Efficacy of holmium laser enucleation of the prostate (HoLEP) in men with bladder outlet obstruction (BOO) and non-neurogenic bladder dysfunction
Kaohsiung Journal of Medical Sciences
Bladder outlet obstruction
Prostatic hyperplasia
Transurethral resection of prostate
title Efficacy of holmium laser enucleation of the prostate (HoLEP) in men with bladder outlet obstruction (BOO) and non-neurogenic bladder dysfunction
title_full Efficacy of holmium laser enucleation of the prostate (HoLEP) in men with bladder outlet obstruction (BOO) and non-neurogenic bladder dysfunction
title_fullStr Efficacy of holmium laser enucleation of the prostate (HoLEP) in men with bladder outlet obstruction (BOO) and non-neurogenic bladder dysfunction
title_full_unstemmed Efficacy of holmium laser enucleation of the prostate (HoLEP) in men with bladder outlet obstruction (BOO) and non-neurogenic bladder dysfunction
title_short Efficacy of holmium laser enucleation of the prostate (HoLEP) in men with bladder outlet obstruction (BOO) and non-neurogenic bladder dysfunction
title_sort efficacy of holmium laser enucleation of the prostate holep in men with bladder outlet obstruction boo and non neurogenic bladder dysfunction
topic Bladder outlet obstruction
Prostatic hyperplasia
Transurethral resection of prostate
url http://www.sciencedirect.com/science/article/pii/S1607551X1630465X
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