MP20-13 Predictors of Post-Operative Incontinence after Holmium Laser Enucleation of the Prostate (HoLEP) for Surgeons Early in their Experience

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology I (MP20)1 May 2024MP20-13 Predictors of Post-Operative Incontinence after Holmium Laser Enucleation of the Prostate (HoLEP) for Surgeons Early in their Experience Karen M. Doersch, Timothy D. Campbell, David Song, Kaela Mali, Laena Hines, Rajat K. Jain, and Scott O. Quarrier Karen M. DoerschKaren M. Doersch , Timothy D. CampbellTimothy D. Campbell , David SongDavid Song , Kaela MaliKaela Mali , Laena HinesLaena Hines , Rajat K. JainRajat K. Jain , and Scott O. QuarrierScott O. Quarrier View All Author Informationhttps://doi.org/10.1097/01.JU.0001008732.80104.31.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To evaluate whether pre-defined factors are predictive of incontinence recovery and time to incontinence recovery following Holmium Laser Enucleation of the Prostate (HoLEP) for two surgeons early in their HoLEP experience. METHODS: A prospectively maintained database was queried for anticipated predictors of incontinence following HoLEP. Both surgeons had performed under 200 HoLEPs as attending physicians. Subjects were included if they had at least 6 months of incontinence data or documented continence post-operatively. Continence was defined as the use of one or fewer pads per day. Statistical analyses were performed using R and Prism and included linear modeling and Mantel-Cox log-rank testing as appropriate. RESULTS: From 12/2020 to 5/2023, 152 subjects met inclusion criteria. Median age was 70 (Range: 51-93). 144/152(94.7%) recovered continence within the study period, with median time to recovery 1.25 months. 112/152 subjects recovered continence within 1 month, with the remaining subjects recovering continence over the following 12 months. Younger age (p=0.01) and shorter enucleation time (p=0.001) were identified as predictors of incontinence by linear modeling (Figure 1a). Preoperative incontinence, body mass index, prostate size, and preoperative catheter dependence were not predictive. Enucleation time less than 100 minutes was predictive of shorter time to continence recovery in those that recovered (p=0.0003) (Figure 1b). CONCLUSIONS: Following HoLEP, continence recovery was predicted by age and enucleation time and time to recovery was predicted by enucleation time. The impact of enucleation time on recovery may be indicative of case difficulty or pressure on the external urethral sphincter during enucleation, which may adversely affect continence recovery. These findings further our understanding of HoLEP outcomes early in a surgeon's learning curve. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e325 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Karen M. Doersch More articles by this author Timothy D. Campbell More articles by this author David Song More articles by this author Kaela Mali More articles by this author Laena Hines More articles by this author Rajat K. Jain More articles by this author Scott O. Quarrier More articles by this author Expand All Advertisement PDF downloadLoading ...