Research output: Contribution to journal › Article › peer-review
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. / Castellani, Daniele; Gauhar, Vineet; Fong, Khi Yung; Sofer, Mario; Socarrás, Moisés Rodríguez; Tursunkulov, Azimdjon N; Ying, Lie Kwok; Biligere, Sarvajit; Tiong, Ho Yee; Elterman, Dean; Mahajan, Abhay; Taratkin, Mark; Ivanovich, Sorokin Nikolai; Bhatia, Tanuj Pal; Enikeev, Dmitry; Gadzhiev, Nariman; Bendigeri, Mohammed Taif; Teoh, Jeremy Yuen-Chun; Dellabella, Marco; Sancha, Fernando Gómez; Somani, Bhaskar Kumar; Herrmann, Thomas Reinhard William.
In: Asian Journal of Andrology, Vol. 26, No. 3, 01.05.2024, p. 233-238.Research output: Contribution to journal › Article › peer-review
}
TY - JOUR
T1 - Incidence of urinary incontinence following endoscopic laser enucleation of the prostate by en-bloc and non-en-bloc techniques
T2 - a multicenter, real-world experience of 5068 patients
AU - Castellani, Daniele
AU - Gauhar, Vineet
AU - Fong, Khi Yung
AU - Sofer, Mario
AU - Socarrás, Moisés Rodríguez
AU - Tursunkulov, Azimdjon N
AU - Ying, Lie Kwok
AU - Biligere, Sarvajit
AU - Tiong, Ho Yee
AU - Elterman, Dean
AU - Mahajan, Abhay
AU - Taratkin, Mark
AU - Ivanovich, Sorokin Nikolai
AU - Bhatia, Tanuj Pal
AU - Enikeev, Dmitry
AU - Gadzhiev, Nariman
AU - Bendigeri, Mohammed Taif
AU - Teoh, Jeremy Yuen-Chun
AU - Dellabella, Marco
AU - Sancha, Fernando Gómez
AU - Somani, Bhaskar Kumar
AU - Herrmann, Thomas Reinhard William
N1 - Copyright © 2024 Copyright: © The Author(s)(2024).
PY - 2024/5/1
Y1 - 2024/5/1
N2 - 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.
AB - 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.
KW - Aged
KW - Endoscopy/adverse effects
KW - Humans
KW - Incidence
KW - Laser Therapy/adverse effects
KW - Male
KW - Middle Aged
KW - Postoperative Complications/epidemiology
KW - Prostatectomy/adverse effects
KW - Prostatic Hyperplasia/surgery
KW - Retrospective Studies
KW - Urinary Incontinence, Stress/surgery
KW - Urinary Incontinence/epidemiology
UR - http://www.ncbi.nlm.nih.gov/pubmed/38265232
UR - https://www.mendeley.com/catalogue/2b47365b-ec1e-3524-8c97-61e5f472ace8/
U2 - 10.4103/aja202375
DO - 10.4103/aja202375
M3 - Article
C2 - 38265232
VL - 26
SP - 233
EP - 238
JO - Asian Journal of Andrology
JF - Asian Journal of Andrology
SN - 1008-682X
IS - 3
ER -
ID: 116270621