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

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Abstract

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.

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Data availability

The data that support the findings of this study are available from corresponding authors upon reasonable request.

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Funding

No funding was received to assist with the preparation of this manuscript. The authors have no relevant financial or non-financial interests to disclose.

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Authors and Affiliations

  1. Department of Urology, Chang Gung Memorial Hospital at Linkou, 333, Taoyuan, Taiwan

    Ying-Hao Hsu, Chen-Pang Hou, Han-Yu Tsai, Shu-Han Tsao, Yu-Hsiang Lin, Chien-Lun Chen, Phei-Lang Chang & Kuo-Jen Lin

  2. School of Medicine, Chang Gung University, 333, Taoyuan, Taiwan

    Chen-Pang Hou

  3. Department of Health and Management, Yuanpei University of Medical Technology, Hsinchu, 330, Taiwan

    Shu-Chuan Weng

  4. Department of Anatomy, School of Medicine, Chang Gung University, 333, Taoyuan, Taiwan

    Horng-Heng Juang

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  1. Ying-Hao Hsu
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Correspondence to Kuo-Jen Lin.

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Hsu, YH., Hou, CP., Weng, SC. et al. Analysis of urinary retention after endoscopic prostate enucleation and its subsequent impact on surgical outcomes. World J Urol 42, 305 (2024). https://doi.org/10.1007/s00345-024-04918-1

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