Use of the anterior prostatic urethral mucosa preservation technique during holmium laser enucleation of the prostate can reduce postoperative stress urinary incontinence.

Autor: Fujisaki Y; Department of Urology, Miyazaki University, Miyazaki, Japan., Otsuka I; Department of Urology, Miyazaki University, Miyazaki, Japan., Kobayashi T; Department of Urology, Nozaki-Higashi Hospital, Miyazaki, Japan., Miyake N; Department of Urology, Miyazaki University, Miyazaki, Japan., Ito K; Department of Urology, Miyazaki University, Miyazaki, Japan., Terada N; Department of Urology, Miyazaki University, Miyazaki, Japan.; Department of Urology, University of Fukui, Fukui, Japan., Kamoto T; Department of Urology, Miyazaki University, Miyazaki, Japan., Iwamoto H; Department of Urology, Nozaki-Higashi Hospital, Miyazaki, Japan.
Jazyk: angličtina
Zdroj: Asian journal of endoscopic surgery [Asian J Endosc Surg] 2024 Jan; Vol. 17 (1), pp. e13256. Date of Electronic Publication: 2023 Oct 26.
DOI: 10.1111/ases.13256
Abstrakt: Introduction: Holmium laser enucleation of the prostate (HoLEP) is an effective and safe surgery for patients with benign prostatic hyperplasia. However, some patients exhibit postoperative urinary incontinence. Here, we compared surgical outcomes and incidence of stress urinary incontinence between HoLEP with and without anterior prostatic urethral mucosa preservation (APUMP).
Methods: All patients in this study underwent HoLEP with APUMP technique (APUMP group) and without APUMP technique (no-APUMP group). Enucleation weight, enucleation time, max flow rate increase at 3 months, and urinary incontinence rates immediately after catheter removal and at 1 month after surgery were compared between the groups.
Results: In the APUMP (n = 340) and no-APUMP (n = 75) groups, the median enucleation weights were 34.5 and 35.0 g, respectively (p = .982). The corresponding median enucleation times were 33.0 and 46.5 min (p < .01), and median max flow rate increases at 1 month were 10.5 and 9.9 mL/s (p = .89). The urinary incontinence rates immediately after catheter removal were 4.1% and 14.7% (p < .01), and were 3.8% and 12.0% (p < .01) at 1 month after surgery.
Conclusion: HoLEP using the APUMP technique could be performed with a shorter operative time while maintaining efficacy. The incidence of postoperative urinary incontinence could be decreased by APUMP, indicating that such preservation facilitates the maintenance of urinary continence after surgery.
(© 2023 Asia Endosurgery Task Force and Japan Society of Endoscopic Surgery and John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE
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