Postoperative Celecoxib Associated with Improved Early Continence and Flow-Rates After Holmium Laser Enucleation of the Prostate

PURPOSE: To assess the impact of celecoxib during the early postoperative period on objective and subjective urinary parameters. Urinary incontinence, persistent hematuria, and bothersome lower urinary tract symptoms are common early postoperative complaints from patients after Holmium Laser Enucleation of the Prostate. To reduce these symptoms, celecoxib was routinely prescribed postoperatively. MATERIALS AND METHODS: Our institution prospectively maintains an IRB-approved single-surgeon database of Holmium-laser enucleations. Beginning in March 2024, eligible patients were prescribed 3 days of postoperative celecoxib and were included in the analysis if they underwent successful same-day trial of void. We used 1:1 propensity-score matching with a caliper of 0.3 for age, body mass index, American Society of Anesthesiologists score, enucleated prostatic tissue, and operative times to identify a control cohort that did not receive celecoxib. Matched cohorts were then compared by 2-week post-operative outcomes using t-tests and Chi-squared analysis with p<0.05. RESULTS: A total of 140 cases were matched to 140 controls from a pool of 550 holmium-laser enucleations performed between January 2020-October 2024. At the initial postoperative visit, celecoxib showed no significant association with rates of delayed urinary retention, hematuria or International Prostate Symptom Score, but was significantly associated with higher urinary flow rates and the absence of urinary incontinence (p<0.05). CONCLUSIONS: Three days of celecoxib was associated with early continence and increased strength of flow in the early postoperative period. These findings lay the foundation for future randomized trials on postoperative celecoxib after holmium-laser enucleations or other urologic procedures.