Effect of Catheter Duration on Prostate Laser Enucleation Surgery Outcomes in Patients With Urinary Retention

Evaluation of the Effect of Catheter Duration on Prostate Laser Enucleation Surgery Outcomes in Patients With Indwelling Catheters Due to Urinary Retention: A Multicenter Study of the Minimally Invasive Urology Society

Benign Prostatic Obstruction (BPO) is a common condition in aging men that can lead to urinary retention, often requiring the use of an indwelling urinary catheter. While laser enucleation of the prostate (such as HoLEP, ThuLEP or ThuFLEP) is a safe and effective surgical treatment, it is not well understood how the length of time a patient spent with a urethral catheter before surgery affects the final surgical outcomes. By analyzing patient data from multiple centers of the Minimally Invasive Urology Society, this study aims to evaluate the impact of preoperative catheterization duration on functional outcomes.

Study Overview

• Status: Recruiting
• Conditions: Urinary Retention; Benign Prostate Obstruction (BPO)
• Intervention / Treatment: Procedure: Laser Enucleation of the Prostate (HoLEP, ThuLEP, ThuFLEP)

Detailed Description

This study is designed as a prospective, observational, multicenter, cohort study conducted under the academic coordination of the Minimally Invasive Urology Society. The study will analyze data from multiple participating centers across Turkey. All clinical parameters will be standardized and recorded in a secure, electronic environment. Preoperative data include patient demographics, catheter duration and baseline urinary scores. Intraoperative data focus on surgical duration and energy parameters. Postoperative data track recovery, complication rates according to the Clavien-Dindo classifications and functional outcomes like flow rates (Qmax), International Prostate Symptom Score (IPSS), post-void residual volume (PVR) at 3 months.

By integrating data from diverse clinical settings, this multicenter study aims to establish a clearer understanding of the optimal timing of surgery, ultimately improving clinical decision-making for patients with urinary retention.

• Study Type: Observational
• Enrollment (Estimated): 54

Contacts and Locations

• Study Contact: Name: Suleyman Oner, MD; Phone Number: +905544064491; Email: dr.suleymanoner@gmail.com
• Study Contact Backup: Name: Cemil Aydin, Professor; Phone Number: +905326960378; Email: cemilaydin78@yahoo.com.tr

Study Locations

• Turkey (Türkiye)
  • Eskişehir
    • Eskişehir, Eskişehir, Turkey (Türkiye), 26040
      • Recruiting
      • Eskisehir Osmangazi University, Faculty of Medicine, Department of Urology
      • Contact: Suleyman Oner, MD; Phone Number: +905544064491; Email: dr.suleymanoner@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: N/A

• Sampling Method: Non-Probability Sample

Study Population

The study population consists of adult male patients presenting to the urology departments of multiple tertiary care hospitals (university and research centers) across Turkey. These patients are characterized by symptomatic benign prostatic obstruction (BPO) and require surgical intervention. Specifically, the population includes individuals who are managed with an indwelling urinary catheter due to urinary retention while awaiting laser enucleation of the prostate (HoLEP, ThuLEP or ThuFLEP).

Description

Inclusion Criteria:

• Patients undergoing laser enucleation of the prostate, including HoLEP, ThuLEP or ThuFLEP procedures, who have an indwelling urinary catheter due to pre-operative urinary retention.

Exclusion Criteria:

• Patients with a diagnosis of neurogenic bladder or prostate cancer.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Short-term Catheterization Group; Patients who have been using an indwelling urinary catheter for less than the average of groups prior to the laser enucleation surgery (HoLEP, ThuLEP, ThuFLEP)	Procedure: Laser Enucleation of the Prostate (HoLEP, ThuLEP, ThuFLEP); Patients undergo endoscopic laser enucleation of the prostate using either Holmium or Thulium laser platforms, depending on the standard equipment and clinical preference of the participating center. The procedure involves the anatomical enucleation of the prostatic adenoma from the surgical capsule, followed by intravesical morcellation of the enucleated tissue. All surgeries are performed by urologists according to established surgical protocols.; Other Names: ThuLEP; HoLEP; ThuFLEP; Holmium Laser Enucleation of the Prostate; Thulium Laser Enucleation of the Prostate; Laser Prostatectomy; Thulium Fiber Laser Enucleation of the Prostate
Long-term Catheterization Group; Patients who have been using an indwelling urinary catheter for more than the average of groups prior to the laser enucleation surgery (HoLEP, ThuLEP, ThuFLEP)	Procedure: Laser Enucleation of the Prostate (HoLEP, ThuLEP, ThuFLEP); Patients undergo endoscopic laser enucleation of the prostate using either Holmium or Thulium laser platforms, depending on the standard equipment and clinical preference of the participating center. The procedure involves the anatomical enucleation of the prostatic adenoma from the surgical capsule, followed by intravesical morcellation of the enucleated tissue. All surgeries are performed by urologists according to established surgical protocols.; Other Names: ThuLEP; HoLEP; ThuFLEP; Holmium Laser Enucleation of the Prostate; Thulium Laser Enucleation of the Prostate; Laser Prostatectomy; Thulium Fiber Laser Enucleation of the Prostate

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in International Prostate Symptom Score (IPSS)	Evaluation of the improvement in urinary functions after laser enucleation of the prostate (HoLEP, ThuLEP, ThuFLEP): The International Prostate Symptom Score (IPSS) is a validated questionnaire used to assess the severity of urinary symptoms. It consists of 7 questions, each scored from 0 to 5. Total score ranges from 0 to 35. Higher scores indicate more severe urinary symptoms (0-7: mild, 8-19: moderate, 20-35: severe).	Baseline and 3 months postoperatively
Change in Peak Urinary Flow Rate (Qmax)	Evaluation of the improvement in urinary functions after laser enucleation of the prostate (HoLEP, ThuLEP, ThuFLEP): Peak urinary flow rate is measured in milliliters per second (mL/s) using uroflowmetry to assess the improvement in urinary flow after the surgical procedure.	Baseline and 3 months postoperatively.
Change in Post-Void Residual Volume (PVR)	Evaluation of the improvement in urinary functions after laser enucleation of the prostate (HoLEP, ThuLEP, ThuFLEP): Post-void residual volume is the amount of urine remaining in the bladder after voiding, measured in milliliters (mL) via transabdominal ultrasound or catheterization.	Baseline and 3 months postoperatively.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative Complication Rate	The frequency and severity of surgical complications occurring after laser enucleation of the prostate (HoLEP, ThuLEP, ThuFLEP). Complications will be categorized and graded using the Clavien-Dindo Classification of Surgical Complications. This scale ranges from Grade I (minor deviations from the normal postoperative course) to Grade V (death of the patient). Higher grades indicate a worse outcome (more severe complications). Grade I: Any deviation from the normal postoperative course without the need for treatment. Grade II: Complications requiring pharmacological treatment Grade III: Complications requiring surgical, endoscopic, or radiological intervention Grade IV: Life-threatening complications requiring intensive care unit (ICU) management Grade V: Death of the patient.	From the date of surgery up to 3 months postoperatively.

Collaborators and Investigators

• Sponsor: Eskişehir Osmangazi University Medicine Faculty Hospital
• Collaborators: Cukurova University; Gazi University; Marmara University; Dokuz Eylul University; Ondokuz Mayıs University; Tepecik Training and Research Hospital; Ankara University; Samsun Education and Research Hospital; Erol Olcok Corum Training and Research Hospital; Izmir Metropolitan Municipality Esrefpasa Hospital
• Investigators: Study Chair: Suleyman Oner, MD, Eskisehir Osmangazi University Faculty of Medicine Hospital

Study record dates

Study Major Dates

• Study Start (Actual): February 4, 2026
• Primary Completion (Estimated): February 4, 2028
• Study Completion (Estimated): February 4, 2029

Study Registration Dates

• First Submitted: May 12, 2026
• First Submitted That Met QC Criteria: May 16, 2026
• First Posted (Actual): May 22, 2026

Study Record Updates

• Last Update Posted (Actual): May 22, 2026
• Last Update Submitted That Met QC Criteria: May 16, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Benign Prostatic Hyperplasia; Lower Urinary Tract Symptoms; BPH; Urology; Multicenter Study; BPO; Urinary Catheterization; HoLEP; Bladder Outlet Obstruction; Prospective Registry; ThuLEP; ThuFLEP; Acute Urinary Retention; Benign Prostatic Obstruction; Holmium Laser Enucleation of the Prostate; Thulium Laser Enucleation of the Prostate; Catheter Duration; Thulium Fiber Laser Enucleation of the Prostate
• Additional Relevant MeSH Terms: Urogenital Diseases; Genital Diseases; Genital Diseases, Male; Prostatic Diseases; Male Urogenital Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urination Disorders; Urological Manifestations; Urinary Bladder Diseases; Urethral Diseases; Urethral Obstruction; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Prostatic Hyperplasia; Lower Urinary Tract Symptoms; Urinary Retention; Urinary Bladder Neck Obstruction; Surgical Procedures, Operative; Urologic Surgical Procedures; Urogenital Surgical Procedures; Urologic Surgical Procedures, Male; Prostatectomy; Transurethral Resection of Prostate
• Other Study ID Numbers: E-25403353-050.04-260029122

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data (IPD) will not be shared due to privacy concerns and data protection regulations, including the Turkish Personal Data Protection Law (KVKK). Only aggregated, de-identified results will be reported in publications and presentations.