Older Age and Larger Prostate Volume Are Associated with Stress Urinary Incontinence after Plasmakinetic Enucleation of the Prostate

Ning Xu, Shao-Hao Chen, Xue-Yi Xue, Yong Wei, Qing-Shui Zheng, Xiao-Dong Li, Jin-Bei Huang, Hai Cai, Xiong-Lin Sun, Yun-Zhi Lin, Ning Xu, Shao-Hao Chen, Xue-Yi Xue, Yong Wei, Qing-Shui Zheng, Xiao-Dong Li, Jin-Bei Huang, Hai Cai, Xiong-Lin Sun, Yun-Zhi Lin

Abstract

Background. To investigate the factors associated with the occurrence of and recovery from stress urinary incontinence (SUI) after plasmakinetic enucleation of the prostate (PKEP). Materials and Methods. This retrospective study enrolled 1,288 patients with benign prostatic hyperplasia treated with plasmakinetic enucleation from January 2008 to January 2015, collecting demographics and clinical parameters. SUI was defined as a patient complaint of involuntary urine leak, including stress or mixed urinary incontinence. Logistic regression analysis was used to investigate the factors associated with the occurrence of SUI. Results. SUI after PKEP occurred in 80 of 1,288 patients (6.2%), 73 of whom (91.3%) recovered within 3 months and 78 of whom (97.5%) recovered within 6 months. In multivariate regression analysis of factors that were significant in univariate analysis, the factors that were significantly associated with postoperative SUI were age ≥ 70 years (odds ratio [OR] = 9.239; 95% confidence interval [CI] = 4.616-18.495; P < 0.001) and prostate volume on transrectal ultrasound ≥ 90 mL (OR = 15.390; 95% CI = 8.077-29.326; P < 0.001). Conclusions. SUI occurred in 6.2% patients after PKEP and was associated with older age and larger prostate volume. We suggest that age and prostate volume be considered in preoperative candidate selection before PKEP to reduce the occurrence of postoperative SUI.

References

    1. Tang J., Yang J. Etiopathogenesis of benign prostatic hypeprlasia. Indian Journal of Urology. 2009;25(3):312–317. doi: 10.4103/0970-1591.56179.
    1. Cornu J.-N., Ahyai S., Bachmann A., et al. A systematic review and meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic obstruction: an update. European Urology. 2015;67(6):1066–1096. doi: 10.1016/j.eururo.2014.06.017.
    1. Mark S., Roger K., Scott D., Chris I. Burden of male lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) - Focus on the UK. BJU International. 2015;115(4):508–519. doi: 10.1111/bju.12745.
    1. Stucki P., Marini L., Mattei A., Xafis K., Boldini M., Danuser H. Bipolar versus monopolar transurethral resection of the prostate: a prospective randomized trial focusing on bleeding complications. The Journal of Urology. 2015;193(4):1371–1376. doi: 10.1016/j.juro.2014.08.137.
    1. Kahokehr A., Gilling P. J. Enucleation techniques for benign prostate obstruction: which one and why? Current Opinion in Urology. 2014;24(1):49–55. doi: 10.1097/mou.0000000000000005.
    1. Michalak J., Tzou D., Funk J. HoLEP: the gold standard for the surgical management of BPH in the 21(st) century. American Journal of Clinical and Experimental Urology. 2015;3:36–42.
    1. Robert G., Cornu J.-N., Fourmarier M., et al. Multicentre prospective evaluation of the learning curve of holmium laser enucleation of the prostate (HoLEP) BJU International. 2016;117(3):495–499. doi: 10.1111/bju.13124.
    1. Liu C., Zheng S., Li H., Xu K. Transurethral enucleation and resection of prostate in patients with benign prostatic hyperplasia by plasma kinetics. Journal of Urology. 2010;184(6):2440–2445. doi: 10.1016/j.juro.2010.08.037.
    1. Chen S., Zhu L., Cai J., et al. 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. European Urology. 2014;66(2):284–291. doi: 10.1016/j.eururo.2014.01.010.
    1. Arai Y., Kaiho Y., Takei M., et al. Burden of male stress urinary incontinence: a survey among urologists in Japan. International Journal of Urology. 2009;16(11):915–917. doi: 10.1111/j.1442-2042.2009.02385.x.
    1. Dutkiewicz S. A. Re: management of lower urinary tract symptoms secondary to benign prostatic hyperplasia with open prostatectomy: results of a contemporary series. B. Helfand, S. Mouli, R. Dedhia and K. T. McVary, J Urol 2006; 176: 2557–2561. The Journal of Urology. 2007;177(6):2398–2399.
    1. Serretta V., Morgia G., Fondacaro L., et al. Open prostatectomy for benign prostatic enlargement in southern Europe in the late 1990s: a contemporary series of 1800 interventions. Urology. 2002;60(4):623–627. doi: 10.1016/s0090-4295(02)01860-5.
    1. Nam J. K., Kim H. W., Lee D. H., Han J., Lee J. Z., Park S. Risk factors for transient urinary incontinence after holmium laser enucleation of the prostate. The World Journal of Men's Health. 2015;33(2):88–94. doi: 10.5534/wjmh.2015.33.2.88.
    1. Rassweiler J., Teber D., Kuntz R., Hofmann R. Complications of Transurethral Resection of the Prostate (TURP)—incidence, management, and prevention. European Urology. 2006;50(5):969–980. doi: 10.1016/j.eururo.2005.12.042.
    1. Hwang J. C., Park S. M., Lee J. B. Holmium laser enucleation of the prostate for benign prostatic hyperplasia: effectiveness, safety, and overcoming of the learning curve. Korean Journal of Urology. 2010;51(9):619–624. doi: 10.4111/kju.2010.51.9.619.
    1. Seki N., Mochida O., Kinukawa N., Sagiyama K., Naito S. Holmium laser enucleation for prostatic adenoma: analysis of learning curve over the course of 70 consecutive cases. The Journal of Urology. 2003;170(5):1847–1850. doi: 10.1097/01.ju.0000092035.16351.9d.
    1. Elmansy H. M., Kotb A., Elhilali M. M. Is there a way to predict stress urinary incontinence after holmium laser enucleation of the prostate? Journal of Urology. 2011;186(5):1977–1981. doi: 10.1016/j.juro.2011.06.063.
    1. Liu C., Zheng S., Li H., Xu K. Transurethral enucleation and resection of prostate in patients with benign prostatic hyperplasia by plasma kinetics. The Journal of Urology. 2010;184(6):2440–2445. doi: 10.1016/j.juro.2010.08.037.
    1. Telli O., Okutucu T. M., Suer E., et al. A prospective, randomized comparative study of monopolar transurethral resection of the prostate versus photoselective vaporization of the prostate with GreenLight 120-W laser, in prostates less than 80 cc. Therapeutic Advances in Urology. 2015;7(1):3–8. doi: 10.1177/1756287214556643.
    1. Luo Y.-H., Shen J.-H., Guan R.-Y., Li H., Wang J. Plasmakinetic enucleation of the prostate vs plasmakinetic resection of the prostate for benign prostatic hyperplasia: comparison of outcomes according to prostate size in 310 patients. Urology. 2014;84(4):904–910. doi: 10.1016/j.urology.2014.06.025.
    1. Griffiths D., Hofner K., Van Mastrigt R., Rollema H. J., Spangberg A., Gleason D. Standardization of terminology of lower urinary tract function: pressure-flow studies of voiding, urethral resistance, and urethral obstruction. Neurourology and Urodynamics. 1997;16(1):1–18. doi: 10.1002/(sici)1520-6777(1997)16:1<1::aid-nau1>;2-i.
    1. Cho M. C., Park J. H., Jeong M. S., et al. Predictor of de novo urinary incontinence following holmium laser enucleation of the prostate. Neurourology & Urodynamics. 2011;30(7):1343–1349. doi: 10.1002/nau.21050.
    1. Gilling P. TURP remains a safe and effective alternative for benign prostatic hyperplasia (BPH) surgery. BJU International. 2014;113(1):5–6. doi: 10.1111/bju.12310.
    1. Palaniappan S., Kuo T. L., Cheng C. W., Foo K. T. Early outcome of transurethral enucleation and resection of prostate compared with transurethral resection of the prostate. Singapore Medical Journal. 2016;57(12):1–15.
    1. Rao J.-M., Xiao H.-J., Ren Y.-X., et al. Did prostate size affect the complication and outcome of plasmakinetic enucleation of the prostate? International Urology and Nephrology. 2014;46(11):2063–2070. doi: 10.1007/s11255-014-0786-y.
    1. Bruschini H., Simonetti R., Antunes A. A., Srougi M. Urinary incontinence following surgery for BPH: the role of aging on the incidence of bladder dysfunction. International Brazilian Journal of Urology. 2011;37(3):380–387. doi: 10.1590/s1677-55382011000300012.
    1. Bauer R. M., Roosen A. Stress urinary incontinence in the aging male: current treatment options. Aging Health. 2011;7(5):763–774. doi: 10.2217/ahe.11.65.

Source: PubMed

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