Analysis of urinary retention after endoscopic prostate enucleation and its subsequent impact on surgical outcomes

• Published in: World journal of urology 2024-05, Vol.42 (1), p.305-305, Article 305
• Main Authors: Hsu, Ying-Hao, Hou, Chen-Pang, Weng, Shu-Chuan, Tsai, Han-Yu, Tsao, Shu-Han, Juang, Horng-Heng, Lin, Yu-Hsiang, Chen, Chien-Lun, Chang, Phei-Lang, Lin, Kuo-Jen
• Format: Article
• Language: English
• Subjects: Aged; Diabetes mellitus (non-insulin dependent); Electronic medical records; Endoscopy; Enucleation; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Nephrology; Oncology; Original Article; Patients; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Prostate; Prostatectomy - adverse effects; Prostatectomy - methods; Prostatic Hyperplasia - surgery; Quality of life; Retrospective Studies; Risk factors; Surgical outcomes; Treatment Outcome; Urinary retention; Urinary Retention - epidemiology; Urinary Retention - etiology; Urology
• ISSN: 1433-8726; 0724-4983; 1433-8726
• DOI: 10.1007/s00345-024-04918-1

Purpose Postoperative urinary retention (PUR) is a common complication after prostate enucleation, which leads to an increased length of hospital stay and decreased postoperative satisfaction. This study determined the predictive factors of postoperative urine retention within 1 month after prostate enucleation and investigated whether PUR influences surgical outcomes at the 2-week, 3-month, and 6-month follow-up time points. Methods Data were collected from the electronic medical records of 191 patients with benign prostatic obstruction (BPO) during October 2018 to September 2021. Of them, 180 patients who underwent thulium laser or plasma kinetic enucleation of the prostate (ThuLEP, PKEP) were separated into the PUR group ( n  = 24) and the non-PUR (NPUR) group ( n  = 156). Uroflowmetry and the International Prostate Symptom Score (IPSS) questionnaire were followed up at 2 weeks, 3 months, and 6 months postoperatively. Results The PUR group had a significantly higher percentage of patients with type 2 diabetes mellitus (DM) than the NPUR group. Postoperatively, compared with the NPUR group, the PUR group had significantly less improvement in changes in the IPSS Quality of Life scores at 2 weeks, the total IPSS(International Prostate Symptom Score) at all follow-up times, the IPSS-S(IPSS storage subscores) at 2 weeks and 3 months, and the IPSS-V(IPSS voiding subscores) at all follow-up times. Predictive factors for PUR include lower preoperative maximum urinary flow (Qmax), lower preoperative total IPSS, and higher operation time. Conclusion Lower preoperative Qmax, lower IPSS scores, and longer operation time were risk factors for PUR. Furthermore, PUR could be a prognostic factor for prostatic enucleation surgical outcomes.