J Sapetti1, J Sakat2, E Saad3, M Zerbib4, O Belas5, C Doru-Pop6, M Peyromaure7, N B Delongchamps8. 1. Hopital Cochin, 75014 Paris, France. Electronic address: j.sapetti@free.fr. 2. Hopital Cochin, 75014 Paris, France. Electronic address: juliensakat@hotmail.fr. 3. Hopital Cochin, 75014 Paris, France. Electronic address: elie.saad@aphp.fr. 4. Hopital Cochin, 75014 Paris, France. Electronic address: marc.zerbib@aphp.fr. 5. Clinique du Pôle santé Sud, 72100 Le MANS, France. Electronic address: belas.olivier@gmail.com. 6. Hopital Cochin, 75014 Paris, France. Electronic address: cristiandorupop@gmx.com. 7. Hopital Cochin, 75014 Paris, France. Electronic address: michael.peyromaure@aphp.fr. 8. Hopital Cochin, 75014 Paris, France. Electronic address: nicolas.barry-delongchamps@aphp.fr.
Abstract
OBJECTIVE: Assess the early morbidity after HOLEP, the urinary incontinence in particular, and specify its different types, evolution, and predictive factors. PATIENTS AND METHODS: We conducted an observational, analytical, retrospective, monocentric study including all patients undergoing surgery for benign prostatic hypertrophy (HBP) by HoLEP between November 2015 and January 2017. The data were collected pre-, per- and postoperatively. The follow-up was for 6 months. RESULTS: One hundred and seventy one patients were included. 23 patients (14.6%) had a complication according to Clavien-Dindo classification [4]: 19 (83%) Clavien 2, 1 (4%) Clavien 3b et 3 (13%) Clavien 4. At one month of the surgery, 64 (42.7%) patients had urinary incontinence of which 55 (86.1%) presented pure stress urinary incontinence. 18 (32.7%) were still incontinent at 6 months of the surgery. The delivered amount of energy during the surgery and the preoperative IIEF5 score were statistically significantly associated with the occurrence rate of stress urinary incontinence. There was no correlation between the surgeon's learning curve and the occurrence of incontinence. CONCLUSION: The occurrence rate of urinary incontinence post HoLEP might be related to the adopted surgical technique ; It is crucial to keep the patient well informed of the risk of this complication postoperatively. LEVEL OF EVIDENCE: 4.
OBJECTIVE: Assess the early morbidity after HOLEP, the urinary incontinence in particular, and specify its different types, evolution, and predictive factors. PATIENTS AND METHODS: We conducted an observational, analytical, retrospective, monocentric study including all patients undergoing surgery for benign prostatic hypertrophy (HBP) by HoLEP between November 2015 and January 2017. The data were collected pre-, per- and postoperatively. The follow-up was for 6 months. RESULTS: One hundred and seventy one patients were included. 23 patients (14.6%) had a complication according to Clavien-Dindo classification [4]: 19 (83%) Clavien 2, 1 (4%) Clavien 3b et 3 (13%) Clavien 4. At one month of the surgery, 64 (42.7%) patients had urinary incontinence of which 55 (86.1%) presented pure stress urinary incontinence. 18 (32.7%) were still incontinent at 6 months of the surgery. The delivered amount of energy during the surgery and the preoperative IIEF5 score were statistically significantly associated with the occurrence rate of stress urinary incontinence. There was no correlation between the surgeon's learning curve and the occurrence of incontinence. CONCLUSION: The occurrence rate of urinary incontinence post HoLEP might be related to the adopted surgical technique ; It is crucial to keep the patient well informed of the risk of this complication postoperatively. LEVEL OF EVIDENCE: 4.