Effect of urinary retention on the surgical outcome of holmium laser enucleation of the benign prostatic hyperplasia
Purpose: To evaluate the effect of urinary retention (UR) on holmium laser enucleation of the prostate (HoLEP) in patients with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms. Materials and Methods: A retrospective analysis of a prospective cohort of patients who underwent HoLE...
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| Format: | Article |
| Language: | English |
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Korean Urological Association
2023-01-01
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| Series: | Investigative and Clinical Urology |
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| Online Access: | https://www.icurology.org/pdf/10.4111/icu.20220232 |
| _version_ | 1797960162250588160 |
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| author | Hyeong Dong Yuk Seung-June Oh |
| author_facet | Hyeong Dong Yuk Seung-June Oh |
| author_sort | Hyeong Dong Yuk |
| collection | DOAJ |
| description | Purpose: To evaluate the effect of urinary retention (UR) on holmium laser enucleation of the prostate (HoLEP) in patients with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms.
Materials and Methods: A retrospective analysis of a prospective cohort of patients who underwent HoLEP between January 2010 and December 2016 was performed. The perioperative factors, including the International Prostate Symptom Score, Overactive Bladder Symptom Score, prostate-specific antigen, urodynamic study results, uroflowmetry results, transrectal ultrasound prostate volume, operative time, morcellation time, enucleation weight, and complications, were evaluated. Postoperative evaluation was performed at 2, 3, and 6 months.
Results: Overall, 903 patients were identified. The mean age and follow-up were 68.3 years and 6 months, respectively. Among the patients, 135 (15.0%) patients had a history of acute UR (AUR), and 36 patients (4.0%) had chronic UR (CUR). The mean detrusor pressures at maximum flow were 64.4, 74.3, and 77.7 cmH2O (p<0.001). The mean maximum flow rates (Qmax) were 7.6, 6.6, and 4.8 mL/s (p<0.001). Additionally, the mean bladder outlet obstruction indices were 49.5, 61.1, and 69.4 (p<0.001). The postoperative Qmax improved in all three groups. The mean postvoid residual volumes (PVRs) were 55, 75, and 333 mL preoperatively; 20, 29, and 66 mL at 2 weeks; 16, 23, and 45 mL at 3 months; and 15, 22, and 52 mL at 6 months (p<0.001).
Conclusions: Voiding symptoms, PVR, and Qmax of BPH patients with preoperative AUR and CUR significantly improved after Ho-LEP, similar to those without preoperative UR. |
| first_indexed | 2024-04-11T00:42:00Z |
| format | Article |
| id | doaj.art-f07adc8461194b1897317405eb85ef95 |
| institution | Directory Open Access Journal |
| issn | 2466-0493 2466-054X |
| language | English |
| last_indexed | 2024-04-11T00:42:00Z |
| publishDate | 2023-01-01 |
| publisher | Korean Urological Association |
| record_format | Article |
| series | Investigative and Clinical Urology |
| spelling | doaj.art-f07adc8461194b1897317405eb85ef952023-01-06T05:09:47ZengKorean Urological AssociationInvestigative and Clinical Urology2466-04932466-054X2023-01-01641314010.4111/icu.20220232Effect of urinary retention on the surgical outcome of holmium laser enucleation of the benign prostatic hyperplasiaHyeong Dong Yuk0https://orcid.org/0000-0002-5874-9167Seung-June Oh1https://orcid.org/0000-0002-0322-3539Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.Purpose: To evaluate the effect of urinary retention (UR) on holmium laser enucleation of the prostate (HoLEP) in patients with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms. Materials and Methods: A retrospective analysis of a prospective cohort of patients who underwent HoLEP between January 2010 and December 2016 was performed. The perioperative factors, including the International Prostate Symptom Score, Overactive Bladder Symptom Score, prostate-specific antigen, urodynamic study results, uroflowmetry results, transrectal ultrasound prostate volume, operative time, morcellation time, enucleation weight, and complications, were evaluated. Postoperative evaluation was performed at 2, 3, and 6 months. Results: Overall, 903 patients were identified. The mean age and follow-up were 68.3 years and 6 months, respectively. Among the patients, 135 (15.0%) patients had a history of acute UR (AUR), and 36 patients (4.0%) had chronic UR (CUR). The mean detrusor pressures at maximum flow were 64.4, 74.3, and 77.7 cmH2O (p<0.001). The mean maximum flow rates (Qmax) were 7.6, 6.6, and 4.8 mL/s (p<0.001). Additionally, the mean bladder outlet obstruction indices were 49.5, 61.1, and 69.4 (p<0.001). The postoperative Qmax improved in all three groups. The mean postvoid residual volumes (PVRs) were 55, 75, and 333 mL preoperatively; 20, 29, and 66 mL at 2 weeks; 16, 23, and 45 mL at 3 months; and 15, 22, and 52 mL at 6 months (p<0.001). Conclusions: Voiding symptoms, PVR, and Qmax of BPH patients with preoperative AUR and CUR significantly improved after Ho-LEP, similar to those without preoperative UR.https://www.icurology.org/pdf/10.4111/icu.20220232benign prostatic hyperplasiaholmium laserprostateprostatectomytransurethral resection of prostate |
| spellingShingle | Hyeong Dong Yuk Seung-June Oh Effect of urinary retention on the surgical outcome of holmium laser enucleation of the benign prostatic hyperplasia Investigative and Clinical Urology benign prostatic hyperplasia holmium laser prostate prostatectomy transurethral resection of prostate |
| title | Effect of urinary retention on the surgical outcome of holmium laser enucleation of the benign prostatic hyperplasia |
| title_full | Effect of urinary retention on the surgical outcome of holmium laser enucleation of the benign prostatic hyperplasia |
| title_fullStr | Effect of urinary retention on the surgical outcome of holmium laser enucleation of the benign prostatic hyperplasia |
| title_full_unstemmed | Effect of urinary retention on the surgical outcome of holmium laser enucleation of the benign prostatic hyperplasia |
| title_short | Effect of urinary retention on the surgical outcome of holmium laser enucleation of the benign prostatic hyperplasia |
| title_sort | effect of urinary retention on the surgical outcome of holmium laser enucleation of the benign prostatic hyperplasia |
| topic | benign prostatic hyperplasia holmium laser prostate prostatectomy transurethral resection of prostate |
| url | https://www.icurology.org/pdf/10.4111/icu.20220232 |
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