Prospective study of urinary incontinence recovery following endoscopic enucleation of the prostate.
Journal
BJU international
ISSN
1464-410X
Date Issued
2024-07-19
Author(s)
Wu, Shao-Wei
Yuan, Lun-Hsiang
Huang, Yu-Wen
Chen, Yi-Jhou
Kuo, Ming-Chieh
Abstract
To investigate the clinical trajectories and identify risk factors linked to post-enucleation urinary incontinence (UI). In this prospective study (April 2020 to March 2022) at a single institution, 316 consecutive patients receiving endoscopic enucleation due to benign prostatic enlargement were included. Patient information and perioperative details were collected. Follow-ups, from 1 to 6 months, assessed postoperative UI using International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form and a four-item pad questionnaire, classified per International Continence Society definitions. Logistic regression analysed predictors at 1 week, while generalised estimating equation assessed risk factors from 1 to 3 months postoperatively. Patients with a median prostate volume of 57 mL underwent enucleation, with 22.5% experiencing postoperative UI at 1 week, 5.6% at 3 months, decreasing to 1.9% at 6 months. Multivariable analysis identified age (>80 years), specimen weight (>70 g), en bloc with anteroposterior dissection, and anal tone (Digital Rectal Examination Scoring System score <3) as potential factors influencing UI. Subgroup analysis revealed that specimen weight was associated with both continuous and stress UI. Anal tone was related to both other types and stress UI, while overactive bladder symptoms were associated with urge UI. In summary, our study elucidates transient risk factors contributing to temporary post-enucleation UI after prostatectomy. Informed decisions and personalised interventions can effectively alleviate concerns regarding postoperative UI.
Subjects
benign prostatic hyperplasia
lower urinary tract symptoms
prostate enucleation
risk factors
urinary incontinence
SDGs
Type
journal article