Change Of Voiding Symptom And Urodynamic Parameters After Holmium Laser Enucleation Of Prostate In Patients With Benign Prostatic Hyperplasia: A Prospective, Pilot Study
Jeong Hwan Son (1), Il Won (1), Dae sung Cho (1), Seok Heun Jang (1), Jae Won Lee (1)
(1) Bundang Jesaeng Hospital, Seongam, South Korea
To report our initial experience and analyze the change of voiding symptom and urodynamic parameters following holmium laser enucleation of the prostate (HoLEP) in patients with benign prostatic hyperplasia.
We evaluated 23 patients with benign prostatic hyperplasia who underwent HoLEP between April 2016 and October 2017. Among them, medical records and Urodynamic study of 12 patients (mean age of 68.9 years) were retrospectively reviewed. We analyzed the results of International Prostate Symptom Score (IPSS), uroflowmetry and urodynamic study (UDS) before and after the surgery. Follow-up examinations and UDS were performed at 6 months after the surgery.
The preoperative serum PSA level was 7.51 (range, 1.03-25.25) ng/mL, and prostate volume was 76.8 (range, 36.7-112.2) mL. Postoperatively, patients showed significant improvement in the IPSS (total score from 26.4 to 4.9, P <0.001), the peak flow rate (P <0.001), and postvoid residual urine volume (P=0.002). In addition, UDS indicated that bladder outlet obstruction index (P <0.001) and maximum urethral closing pressure (P <0.001) have improved significantly after operation. The patients with detrusor overactivity in UDS decreased significantly from 41.7% to 8.3% (P <.001).
Patients who underwent HoLEP showed improved voiding symptoms and UDS parameters. In addition, UDS findings of decrease in patients with detrusor overactivity and increased maximum urethral closing pressure after HoLEP might indicate some role on the improvement of storage symptoms and positive effect on the degree of incontinence.