Stress urinary incontinence after holmium laser enucleation of prostate: incidence and risk factors
1Department of Urology and Transplantation Surgery, Hospital Edouard Herriot, Hospices Civil de Lyon, 69003 Lyon, France
DOI: 10.31083/jomh.2021.129 Vol.18,Issue 1,January 2022 pp.1-7
Submitted: 19 May 2021 Accepted: 08 July 2021
Published: 31 January 2022
*Corresponding Author(s): Haixia Ye E-mail: firstname.lastname@example.org
Background and objective: To evaluate the incidence and the risk factors of stress urinary incontinence (SUI) during the first year following Holmium Laser Enucleation of the Prostate (HoLEP).
Materials and methods: Our monocentric and retrospective study includes 155 patients who underwent HoLEP for benign prostatic hyperplasia. Surgeries were performed by 2 expert surgeons. The continence was evaluated before and after surgery at 1, 3, 6 and 12 months. The predictive factors of SUI were analysed using logistic regression.
Results: The SUI rate at 1, 3, 6 and 12 months was respectively 7.3%, 8.1%, 3.4% and 2.7%. SUI remained present in 4 patients (2.6%) at 12 months. The mean International Consultation Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-SF) score for patients with SUI was respectively 11.69 ± 5.28, 8.70 ± 4.24, 1.81 ± 3.53 and 8 ± 4.24 at 1, 3, 6 and 12 months (p < 0.05). Body Mass Index (BMI) >30 (Odds Ratio (OR), 4.69; 95% Confidence Interval (CI), 1.51–14.52; p = 0.007) and patients over 70 years old (OR, 16.23; 95% CI, 1.96–134.09; p = 0.010) were respectively identified as independent risk factors for SUI at 1 and 3 months.
Conclusions: SUI after HoLEP is transitory in most cases. It is favoured by a high BMI and an age over 70. These criteria should be considered before choosing the operative technique and preventive measures must be taken in high-risk patients.
Laser; Prostatic hyperplasia; Urinary incontinence; Holmium
Haixia Ye,Ricardo Codas,Theresa Daily,Lionel Badet,Marc Colombel,Hakim Fassi-Fehri. Stress urinary incontinence after holmium laser enucleation of prostate: incidence and risk factors. Journal of Men's Health. 2022. 18(1);1-7.
 Reich O, Gratzke C, Bachmann A, Seitz M, Schlenker B, Hermanek P, et al. Morbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10,654 patients. Journal of Urology. 2008; 180: 246–249.
 Serretta V, Morgia G, Fondacaro L, Curto G, Lo bianco A, Pirritano D, et al. Open prostatectomy for benign prostatic enlargement in southern Europe in the late 1990s: a contemporary series of 1800 interventions. Urology. 2002; 60: 623–627.
 Elzayat EA, Habib EI, Elhilali MM. Holmium laser enucleation of the prostate: a size-independent new “gold standard”. Urology. 2005; 66: 108–113.
 Cornu J-N, Ahyai S, Bachmann A, de la Rosette J, Gilling P, Gratzke C, 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: 1066–1096.
 Cho MC, Park JH, Jeong MS, Yi JS, Ku JH, Oh SJ, et al. Predictor of de novo urinary incontinence following holmium laser enucleation of the prostate. Neurourology and Urodynamics. 2011; 30: 1343–1349.
 Montorsi F, Naspro R, Salonia A, Suardi N, Briganti A, Zanoni M, et al. Holmium laser enucleation versus transurethral resection of the prostate: results from a 2-center, prospective, randomized trial in patients with obstructive benign prostatic hyperplasia. Journal of Urology. 2004; 172: 1926–1929.
 Nam JK, Kim HW, Lee DH, Han JY, Lee JZ, Park SW. Risk Factors for Transient Urinary Incontinence after Holmium Laser Enucleation of the Prostate. World Journal of Men’s Health. 2015; 33: 88–94.
 Anderson CA, Omar MI, Campbell SE, Hunter KF, Cody JD, Glazener CMA. Conservative management for postprostatectomy urinary incontinence. Cochrane Database of Systematic Reviews. 2015; 1: CD001843.
 Theodorou C, Moutzouris G, Floratos D, Plastiras D, Katsifotis C, Mertziotis N. Incontinence after surgery for benign prostatic hypertrophy: the case for complex approach and treatment. European Urology. 1998; 33: 370–375.
 Shah HN, Mahajan AP, Hegde SS, Bansal MB. Peri-operative compli-cations of holmium laser enucleation of the prostate: experience in the first 280 patients, and a review of literature. BJU International. 2007; 100: 94–101.
 Shigemura K, Tanaka K, Yamamichi F, Chiba K, Fujisawa M. Compar-ison of Predictive Factors for Postoperative Incontinence of Holmium Laser Enucleation of the Prostate by the Surgeons’ Experience During Learning Curve. International Neurourology Journal. 2016; 20: 59–68.
 Lerner LB, Tyson MD, Mendoza PJ. Stress incontinence during the learning curve of holmium laser enucleation of the prostate. Journal of Endourology. 2010; 24: 1655–1658.
 Minagawa S, Okada S, Morikawa H. Safety and Effectiveness of Holmium Laser Enucleation of the Prostate Using a Low-power Laser. Urology. 2017; 110: 51–55.
 Placer J, Gelabert-Mas A, Vallmanya F, Manresa JM, Menéndez V, Cortadellas R, et al. Holmium laser enucleation of prostate: outcome and complications of self-taught learning curve. Urology. 2009; 73: 1042–1048.
 Gilling PJ, Cass CB, Cresswell MD, Fraundorfer MR. Holmium laser resection of the prostate: preliminary results of a new method for the treatment of benign prostatic hyperplasia. Urology. 1996; 47: 48–51.
 Duarte RC, Daily T, Fassi-Fehri H. V68 - HoLEP dangers: How to avoid them. European Urology Supplements. 2018; 17: e1981.
 Houssin V, Olivier J, Brenier M, Pierache A, Laniado M, Mouton M, et al. Predictive factors of urinary incontinence after holmium laser enucleation of the prostate: a multicentric evaluation. World Journal of Urology. 2020; 39: 143–148.
 Helfand BT, Smith AR, Lai HH, Yang CC, Gore JL, Erickson BA, et al. Prevalence and Characteristics of Urinary Incontinence in a Treatment Seeking Male Prospective Cohort: Results from the LURN Study. Journal of Urology. 2018; 200: 397–404.
 Twiss CO, Fischer MC, Nitti VW. Comparison between reduction in 24-hour pad weight, International Consultation on Incontinence-Short Form (ICIQ-SF) score, International Prostate Symptom Score (IPSS), and Post-Operative Patient Global Impression of Improvement (PGI-I) score in patient evaluation after male perineal sling. Neu-rourology and Urodynamics. 2007; 26: 8–13.
 Kobayashi S, Yano M, Nakayama T, Kitahara S. Predictive risk factors of postoperative urinary incontinence following holmium laser enucleation of the prostate during the initial learning period. International Brazilian Journal of Urology. 2016; 42: 740–746.
 Jeong J, Lee HS, Cho WJ, Jung W, You HW, Kim TH, et al. Effect of Detrusor Overactivity on Functional Outcomes After Holmium Laser Enucleation of the Prostate in Patients With Benign Prostatic Obstruction. Urology. 2015; 86: 133–138.
 Vavassori I, Valenti S, Naspro R, Vismara A, Dell’Acqua V, Manzetti A, et al. Three-year outcome following holmium laser enucleation of the prostate combined with mechanical morcellation in 330 consecutive patients. European Urology. 2008; 53: 599–604.
 Elmansy HM, Kotb A, Elhilali MM. Holmium Laser Enucleation of the Prostate: Long-Term Durability of Clinical Outcomes and Complication Rates During 10 Years of Followup. Journal of Urology. 2011; 186: 1972–1976.
 Krambeck AE, Handa SE, Lingeman JE. Experience With More Than 1,000 Holmium Laser Prostate Enucleations for Benign Prostatic Hyperplasia. Journal of Urology. 2013; 189: S141–S145.
 Elmansy H, Hodhod A, Kotb A, Prowse O, Shahrour W. Top-down Holmium Laser Enucleation of the Prostate: Technical Aspects and Early Outcomes. Urology. 2019; 126: 236.
 Lai HH, Helmuth ME, Smith AR, Wiseman JB, Gillespie BW, Kirkali Z. Relationship Between Central Obesity, General Obesity, Overactive Bladder Syndrome and Urinary Incontinence Among Male and Female Patients Seeking Care for Their Lower Urinary Tract Symptoms. Urology. 2019; 123: 34–43.
 Scoffone CM, Cracco CM. The en-bloc no-touch holmium laser enucleation of the prostate (HoLEP) technique. World Journal of Urology. 2016; 34: 1175–1181.
 Gomez Sancha F, Rivera VC, Georgiev G, Botsevski A, Kotsev J, Herrmann T. Common trend: move to enucleation -is there a case for GreenLight enucleation? Development and description of the technique. World Journal of Urology. 2015; 33: 539–547.
 Endo F, Shiga Y, Minagawa S, Iwabuchi T, Fujisaki A, Yashi M, et al. Anteroposterior dissection HoLEP: a modification to prevent transient stress urinary incontinence. Urology. 2010; 76: 1451–1455.
 Cochetti G, Del Zingaro M, Panciarola M, Paladini A, Guiggi P, Ciarletti S, et al. Safety and Efficacy of a Modified Technique of Holmium Laser Enucleation of the Prostate (HoLEP) for Benign Prostatic Hyperplasia. Applied Sciences. 2021; 11: 2467.
 Kampantais S, Dimopoulos P, Tasleem A, Acher P, Gordon K, Young A. Assessing the Learning Curve of Holmium Laser Enucleation of Prostate (HoLEP). A Systematic Review. Urology. 2018; 120: 9–22.
 Shigemura K, Yamamichi F, Kitagawa K, Yamashita M, Oka Y, Tanaka H, et al. Does Surgeon Experience Affect Operative Time, Adverse Events and Continence Outcomes in Holmium Laser Enucleation of the Prostate? A Review of More Than 1,000 Cases. Journal of Urology. 2017; 198: 663–670.
 Aho T, Herrmann TRW. Description of a modular mentorship programme for holmium laser enucleation of the prostate. World Journal of Urology. 2015; 33: 497–502.
Vol., Issue , Invalid dateTable of contents
Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.
Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.
Directory of Open Access Journals (DOAJ) DOAJ is a unique and extensive index of diverse open access journals from around the world, driven by a growing community, committed to ensuring quality content is freely available online for everyone.
SCImago The SCImago Journal & Country Rank is a publicly available portal that includes the journals and country scientific indicators developed from the information contained in the Scopus® database (Elsevier B.V.)
Publication Forum - JUFO (Federation of Finnish Learned Societies) Publication Forum is a classification of publication channels created by the Finnish scientific community to support the quality assessment of academic research.
Scopus CiteScore 0.7 (2021) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.
Norwegian Register for Scientific Journals, Series and Publishers Search for publication channels (journals, series and publishers) in the Norwegian Register for Scientific Journals, Series and Publishers to see if they are considered as scientific. (https://kanalregister.hkdir.no/publiseringskanaler/Forside).