To evaluate complications and urinary incontinence (UI) after endoscopic enucleation of the prostate (EEP) stratified by prostate volume (PV).
We retrospectively reviewed patients with benign prostatic hyperplasia who underwent EEP with different energy sources in 14 centers (January 2019-January 2023).
prostate volume ≥ 80 ml.
prostate cancer, previous prostate/urethral surgery, pelvic radiotherapy.
complication rate.
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.
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.
PV has no influence on complication and UI rates following EEP. Age is risk factor of postoperative UI.
World journal of urology. 2024 Mar 20*** epublish ***
Vineet 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
Department of Urology, Ng Teng Fong General Hospital, Singapore, Singapore., Urology Unit, IRCCS INRCA, Ancona, Italy. ., Department of Urology, Kantonspital Frauenfeld, Spital Thurgau AG, Frauenfeld, Switzerland., Department of Urology, Ankara University School of Medicine, Ankara, Turkey., Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Department of Urology, Saint-Petersburg State University Hospital, Saint-Petersburg, Russian Federation., Urology Unit, A.I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russian Federation., Urology Unit, San Giuseppe Hospital, IRCCS Multimedica, Multimedica Group, Milan, Italy., Sai Urology Hospital and Mahatma Gandhi Mission's Medical College and Hospital, Aurangabad, India., Urology Unit, Fortis Hospital Mulund, Mumbai, India., Urology Division, AkfaMedline Hospital, Tashkent, Uzbekistan., Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russian Federation., Urology Unit, IRCCS INRCA, Ancona, Italy., Department of Urology, Singapore General Hospital, Singapore, Singapore., Department of Urology and Robotic Surgery, ICUA-Clínica CEMTRO, Madrid, Spain., Urology Unit, St. Anna Hospital, Piaseczno, Poland., Andrology and Urology Unit, Bonomo Teaching Hospital, Andria, Italy., Department of Urology, Ospedali Riuniti di Foggia, University of Foggia, Foggia, Italy., S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China., Department of Urology, University Hospitals Southampton, NHS Trust, Southampton, UK., Department of Urology, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.