[One year follow-up results of urinary incontinence and sexual function after holmium laser enucleation of the prostate].
We performed holmium laser enucleation of the prostate (HoLEP) on 98 patients between February 2005 and February 2007. Seventy five patients with the mean age of 68.9 (ranging 55-84) were assessed preoperatively and followed up at 1, 3 and 12 months postoperatively. Before and after HoLEP, International Prostate Symptom Score (IPSS), quality of life (QOL) index, maximum flow rate (Qmax) and post-void residual (PVR) urine were all improved significantly (P < 0.001). When urinary incontinence was strictly defined as International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) scores > or = 1, incontinence was observed in 71% of patients preoperatively. ICIQ-SF scores were increased from 5.2 preoperatively to 8.0 at 1 month postoperatively, but improved thereafter and had decreased significantly to 2.5 (p < 0.05 compared with baseline) at 12 months. Univariate and multivariate logistic regression analysis revealed date of operation and operation time were significantly (P < 0.05) correlated with postoperative stress urinary incontinence (SUI) at 1 month and enucleated volume was of borderline significance (p = 0.052) at 12 months. In terms of sexual function, mean IIEF5 scores were not significantly changed, but we could classify the scores into five types of response-unchanging (64%), improving (13%), worsening (11%), transient worsening (9%) and unclassified (2%). HoLEP is an effective treatment for BPH. Urinary incontinence improved by 1 year. HoLEP does not appear to affect sexual function, but various clinical courses were observed.
Shiraishi
Yusuke
Y
Department of Urology, Postgraduate School of Medicine, Kyoto University.
Yoshimura
Koji
K
Inoue
Takahiro
T
Okubo
Kazutoshi
K
Watanabe
Jun
J
Kamba
Tomomi
T
Kanematsu
Akihiro
A
Nakamura
Eijiro
E
Nishiyama
Hiroyuki
H
Kamoto
Toshiyuki
T
Ogawa
Osamu
O
D000368:Aged; D000369:Aged, 80 and over; D007172:Erectile Dysfunction / Q000453:epidemiology*; D005500:Follow-Up Studies; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011468:Prostatectomy / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000601:surgery*; D012044:Regression Analysis; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000453:epidemiology*