New-Onset Urinary Incontinence Common After HoLEP for BPH

New-Onset Urinary Incontinence Common After HoLEP for BPH

BOSTON — Transient de novo urinary incontinence develops in as many as 1 in 3 benign prostatic hyperplasia (BPH) patients following treatment with holmium laser enucleation of the prostate (HoLEP), investigators reported at the American Urological Association meeting.

The team also identified post-void residual (PVR) urine volume as a key predictor of de novo UI.

“High PVR urine volume after removal of postoperative urethral catheter is associated with de novo UI after HoLEP, and could be used as a practical tool to predict postoperative de novo UI,” Jun Seok Kim, MD, of Kwangju Christian Hospital in Korea, and colleagues concluded.
In a study that included 141 patients who underwent HoLEP, de novo UI developed in 44 (31.2%). Stress UI, urgency UI, and mixed UI, as defined by the International Continence Society, occurred in 34, 6, and 4 patients, respectively. Most cases resolved within 6 months.

To identify factors associated with de novo UI, Jun Seok Kim, MD, of Kwangju Christian Hospital in Korea, and colleagues used logistic regression to assess age, prostate volume, retrieved tissue weight, operative time, and first PVR after removal of the postoperative urethral catheter. Results showed that age (75.09 vs 72.01 years) and PVR (81.88 vs 30.15 mL) were significantly higher in the de novo UI group.

Only PVR urine volume proved an independent predictor of de novo UI after HoLEP. The optimal cutoff was 39.5 mL with an area under the curve of 0.815 and 75.0% sensitivity, 74.2% specificity. “Postoperative first-PVR urine volume could be used as a practical tool to predict postoperative transient UI,” according to Dr Kim's team.