» Articles » PMID: 38724829

Analysis of Urinary Retention After Endoscopic Prostate Enucleation and Its Subsequent Impact on Surgical Outcomes

Overview
Journal World J Urol
Specialty Urology
Date 2024 May 9
PMID 38724829
Authors
Affiliations
Soon will be listed here.
Abstract

Purpose: Postoperative urinary retention (PUR) is a common complication after prostate enucleation, which leads to an increased length of hospital stay and decreased postoperative satisfaction. This study determined the predictive factors of postoperative urine retention within 1 month after prostate enucleation and investigated whether PUR influences surgical outcomes at the 2-week, 3-month, and 6-month follow-up time points.

Methods: Data were collected from the electronic medical records of 191 patients with benign prostatic obstruction (BPO) during October 2018 to September 2021. Of them, 180 patients who underwent thulium laser or plasma kinetic enucleation of the prostate (ThuLEP, PKEP) were separated into the PUR group (n = 24) and the non-PUR (NPUR) group (n = 156). Uroflowmetry and the International Prostate Symptom Score (IPSS) questionnaire were followed up at 2 weeks, 3 months, and 6 months postoperatively.

Results: The PUR group had a significantly higher percentage of patients with type 2 diabetes mellitus (DM) than the NPUR group. Postoperatively, compared with the NPUR group, the PUR group had significantly less improvement in changes in the IPSS Quality of Life scores at 2 weeks, the total IPSS(International Prostate Symptom Score) at all follow-up times, the IPSS-S(IPSS storage subscores) at 2 weeks and 3 months, and the IPSS-V(IPSS voiding subscores) at all follow-up times. Predictive factors for PUR include lower preoperative maximum urinary flow (Qmax), lower preoperative total IPSS, and higher operation time.

Conclusion: Lower preoperative Qmax, lower IPSS scores, and longer operation time were risk factors for PUR. Furthermore, PUR could be a prognostic factor for prostatic enucleation surgical outcomes.

References
1.
Lim K . Epidemiology of clinical benign prostatic hyperplasia. Asian J Urol. 2017; 4(3):148-151. PMC: 5717991. DOI: 10.1016/j.ajur.2017.06.004. View

2.
Lerner L, McVary K, Barry M, Bixler B, Dahm P, Das A . Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA GUIDELINE PART II-Surgical Evaluation and Treatment. J Urol. 2021; 206(4):818-826. DOI: 10.1097/JU.0000000000002184. View

3.
Cornu J . Bipolar, Monopolar, Photovaporization of the Prostate, or Holmium Laser Enucleation of the Prostate: How to Choose What's Best?. Urol Clin North Am. 2016; 43(3):377-84. DOI: 10.1016/j.ucl.2016.04.006. View

4.
Li M, Qiu J, Hou Q, Wang D, Huang W, Hu C . Endoscopic enucleation versus open prostatectomy for treating large benign prostatic hyperplasia: a meta-analysis of randomized controlled trials. PLoS One. 2015; 10(3):e0121265. PMC: 4380430. DOI: 10.1371/journal.pone.0121265. View

5.
Chen S, Zhu L, Cai J, Zheng Z, Ge R, Wu M . Plasmakinetic enucleation of the prostate compared with open prostatectomy for prostates larger than 100 grams: a randomized noninferiority controlled trial with long-term results at 6 years. Eur Urol. 2014; 66(2):284-91. DOI: 10.1016/j.eururo.2014.01.010. View