Incidence of complications and urinary incontinence following endoscopic enucleation of the prostate in men with a prostate volume of 80 ml and above: results from a multicenter, real-world experience of 2512 patients
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AbstractPurpose
To evaluate complications and urinary incontinence (UI) after endoscopic enucleation of the prostate (EEP) stratified by prostate volume (PV).
Methods
We retrospectively reviewed patients with benign prostatic hyperplasia who underwent EEP with different energy sources in 14 centers (January 2019–January 2023). Inclusion criteria: prostate volume ≥ 80 ml. Exclusion criteria: prostate cancer, previous prostate/urethral surgery, pelvic radiotherapy.
Primary outcome: complication rate. Secondary outcomes: incidence of and factors affecting postoperative UI. Patients were divided into 3 groups. Group 1: PV = 80–100 ml; Group 2 PV = 101–200 ml; Group 3 PV > 200 ml. Multivariable logistic regression analysis was performed to evaluate independent predictors of overall incontinence.
Results
There were 486 patients in Group 1, 1830 in Group 2, and 196 in Group 3. The most commonly used energy was high-power Holmium laser followed by Thulium fiber laser in all groups. Enucleation, morcellation, and total surgical time were significantly longer in Group 2. There was no significant difference in overall 30-day complications and readmission rates. Incontinence incidence was similar (12.1% in Group 1 vs. 13.2% in Group 2 vs. 11.7% in Group 3, p = 0.72). The rate of stress and mixed incontinence was higher in Group 1. Multivariable regression analysis showed that age (OR 1.019 95% CI 1.003–1.035) was the only factor significantly associated with higher odds of incontinence.
Conclusions
PV has no influence on complication and UI rates following EEP. Age is risk factor of postoperative UI.
To evaluate complications and urinary incontinence (UI) after endoscopic enucleation of the prostate (EEP) stratified by prostate volume (PV).
Methods
We retrospectively reviewed patients with benign prostatic hyperplasia who underwent EEP with different energy sources in 14 centers (January 2019–January 2023). Inclusion criteria: prostate volume ≥ 80 ml. Exclusion criteria: prostate cancer, previous prostate/urethral surgery, pelvic radiotherapy.
Primary outcome: complication rate. Secondary outcomes: incidence of and factors affecting postoperative UI. Patients were divided into 3 groups. Group 1: PV = 80–100 ml; Group 2 PV = 101–200 ml; Group 3 PV > 200 ml. Multivariable logistic regression analysis was performed to evaluate independent predictors of overall incontinence.
Results
There were 486 patients in Group 1, 1830 in Group 2, and 196 in Group 3. The most commonly used energy was high-power Holmium laser followed by Thulium fiber laser in all groups. Enucleation, morcellation, and total surgical time were significantly longer in Group 2. There was no significant difference in overall 30-day complications and readmission rates. Incontinence incidence was similar (12.1% in Group 1 vs. 13.2% in Group 2 vs. 11.7% in Group 3, p = 0.72). The rate of stress and mixed incontinence was higher in Group 1. Multivariable regression analysis showed that age (OR 1.019 95% CI 1.003–1.035) was the only factor significantly associated with higher odds of incontinence.
Conclusions
PV has no influence on complication and UI rates following EEP. Age is risk factor of postoperative UI.
Acceptance Date12/02/2024
All Author(s) ListVineet Gauhar, Daniele Castellani, Thomas R. W. Herrmann, Mehmet Ilker Gökce, Khi Yung Fong, Nariman Gadzhiev, Vigen Malkhasyan, Giacomo Maria Pirola, Angelo Naselli, Abhay Mahajan, Pankaj Nandkishore Maheshwari, Sarvajit Biligere, Azimdjon N. Tursunkulov, Furkat Nasirov, Vladislav Petov, Marco Dellabella, Ee Jean Lim, Moisés Rodríguez Socarrás, Marek Zawadzki, Luigi Cormio, Gian Maria Busetto, Jeremy Yuen-Chun Teoh, Bhaskar Kumar Somani, Dmitry Enikeev, Mario Sofer & Fernando Gómez Sancha
Journal nameWorld Journal of Urology
Year2024
Month3
Day20
Volume Number42
Issue Number1
PublisherSpringer
Article number180
ISSN0724-4983
eISSN1433-8726
LanguagesEnglish-United Kingdom
KeywordsEndoscopic enucleation of the prostate; Laser therapy; Postoperative complications; Prostatic hyperplasia; Urinary incontinence.
