|
Volume 26, Issue 3 (May 2024) 26, 233–238; 10.4103/aja202375
Incidence of urinary incontinence following endoscopic laser enucleation of the prostate by en-bloc and non-en-bloc techniques: a multicenter, real-world experience of 5068 patients
Daniele Castellani1,2, Vineet Gauhar3, Khi Yung Fong4, Mario Sofer5, Moisés Rodríguez Socarrás6, Azimdjon N Tursunkulov7, Lie Kwok Ying3,8, Sarvajit Biligere3, Ho Yee Tiong9, Dean Elterman10, Abhay Mahajan11, Mark Taratkin12, Sorokin Nikolai Ivanovich13, Tanuj Pal Bhatia14, Dmitry Enikeev15, Nariman Gadzhiev16, Mohammed Taif Bendigeri17, Jeremy Yuen-Chun Teoh18, Marco Dellabella1, Fernando Gómez Sancha6, Bhaskar Kumar Somani19, Thomas Reinhard William Herrmann20
1Urology Unit, IRCCS INRCA, Ancona 60127, Italy; 2Urology Unit, Marche University Hospital, Le Marche Polytechnic University, Ancona 60126, Italy; 3Department of Urology, Ng Teng Fong General Hospital, Singapore 609606, Singapore; 4Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; 5Department of Urology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel; 6Department of Urology and Robotic Surgery, ICUA-Clínica CEMTRO, Madrid 28701, Spain; 7Urology Division, AkfaMedline Hospital, Tashkent 100211, Uzbekistan; 8Advanced Urology, Gleneagles Hospital, Singapore 258499, Singapore; 9Department of Urology, National University Hospital, Singapore 119228, Singapore; 10Division
of Urology, Department of Surgery, University of Toronto, Ontario, Toronto M5G 2C4, Canada; 11Department of Urology, Mahatma Gandhi Mission’s Medical College and Hospital, Aurangabad 431003, India; 12Institute for Urology and Reproductive Health, Sechenov University, Moscow119435, Russian Federation; 13Department of Urology and Andrology, Lomonosov Moscow State University, Moscow 119992, Russian Federation; 14Department of Urology, Sarvodaya Hospital and Research Centre, Faridabad, Haryana 121006, India; 15Department of Urology, Medical University of Vienna, Vienna 1090, Austria; 16Department of Urology, Saint-Petersburg State University Hospital, Saint-Petersburg 199034, Russian Federation; 17Department of Urology, Asian Institute of Nephrology and Urology, Hyderabad 500082, India; 18S.H. Ho Urology
Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 96H2+Q9, China; 19Department of Urology, University Hospitals Southampton NHS Trust, Southampton SO16 6YD, United Kingdom; 20Department of Urology, Cantonal Hospital Thurgau AG, Fraunfeld 8500, Switzerland.
Correspondence: Daniele Castellani
Received: 08 September 2023; Accepted: 16 November 2023; published online: 23 January 2024
| Abstract |
|
We aim to evaluate the incidence of incontinence following laser endoscopic enucleation of the prostate (EEP) comparing en-bloc (Group 1) versus 2-lobe/3-lobe techniques (Group 2). We performed a retrospective review of patients undergoing EEP for benign prostatic enlargement in 12 centers between January 2020 and January 2022. Data were presented as median and interquartile range (IQR). Univariable and multivariable logistic regression analysis was performed to evaluate factors associated with stress urinary incontinence (SUI) and mixed urinary incontinence (MUI). There were 1711 patients in Group 1 and 3357 patients in Group 2. Patients in Group 2 were significantly younger (68 [62–73] years vs 69 [63–74] years, P = 0.002). Median (interquartile range) prostate volume (PV) was similar between the groups (70 [52–92] ml in Group 1 vs 70 [54–90] ml in Group 2, P = 0.774). There was no difference in preoperative International Prostate Symptom Score, quality of life, or maximum flow rate. Enucleation, morcellation, and total surgical time were significantly shorter in Group 1. Within 1 month, overall incontinence rate was 6.3% in Group 1 versus 5.3% in Group 2 (P = 0.12),
and urge incontinence was significantly higher in Group 1 (55.1% vs 37.3% in Group 2, P < 0.001). After 3 months, the overall rate of incontinence was 1.7% in Group 1 versus 2.3% in Group 2 (P = 0.06), and SUI was significantly higher in Group 2 (55.6% vs 24.1% in Group 1, P = 0.002). At multivariable analysis, PV and IPSS were factors significantly associated with higher odds of transient SUI/MUI. PV, surgical time, and no early apical release technique were factors associated with higher odds of persistent SUI/MUI.
Full Text |
PDF |
|
| |
| Browse: 221 |
|
