OBJECTIVE: To analyze the effect of Holmium laser enucleation of prostate (HoLEP) on overactive bladder (OAB) symptoms and urodynamic parameters in patients with benign prostatic hyperplasia.
METHODS: One hundred sixty-five patients were included in this prospective study. They complained of lower urinary tract symptoms suggestive of benign prostatic hyperplasia and underwent HoLEP by a surgeon from January 2010 to March 2012. We analyzed the results of International Prostate Symptom Score, overactive bladder questionnaire, frequency-volume chart, and urodynamic studies (UDS) before and after the surgery. Follow-up examinations were repeated 3 and 6 months postoperatively, and a UDS was performed at 6 months after the surgery.
RESULTS: The mean age was 68.4 (range, 52-91) years, the preoperative prostate volume measured by transrectal ultrasound was 71.1 (range, 22-202) mL, and the serum PSA level was 4.4 (range, 0.5-21.7) ng/mL. Postoperatively, patients showed significant improvement in the International Prostate Symptom Score (total score from 20.7 to 5.5, P <.001), overactive bladder questionnaire score (severity score from 24.8 to 12.5, P <.001), and frequency-volume chart parameters (daytime frequency, nocturia, and maximal capacity, respectively) (P <.001). The peak flow rate (P <.001), postvoid residual urine volume (P <.001), maximal cystometric capacity (P <.002), and bladder outlet obstruction index (P <.001) have improved significantly. The number of patients who showed involuntary detrusor contraction in UDS decreased significantly from 45.5% to 36.4% (P <.001). However, bladder compliance did not improve.
CONCLUSION: OAB symptoms and urodynamic parameters were improved significantly after HoLEP surgery in short-term follow-up.
Written by:
Kwon O1, Lee HE1, Bae J2, Oh JK3, Oh SJ4 Are you the author?
1Department of Urology, Seoul National University Hospital, Seoul, South Korea. 2Department of Urology, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, South Korea. 3Department of Urology, Gachon University Gil Hospital, Incheon, South Korea. 4Department of Urology, Seoul National University Hospital, Seoul, South Korea. Electronic address: .
Reference: Urology. 2013 Dec 24 (Epub ahead of print)
doi: 10.1016/j.urology.2013.10.037
PubMed Abstract
PMID: 24373317
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