title: Predictive risk factors of postoperative urinary incontinence following holmium laser enucleation of the prostate during the initial learning period.
abstract: OBJECTIVE
  To determine the predictive factors for postoperative urinary incontinence (UI) following holmium laser enucleation of the prostate (HoLEP) during the initial learning period.
  
  
  METHODS
  We evaluated 127 patients with benign prostatic hyperplasia who underwent HoLEP between January 2011 and December 2013. We recorded clinical variables, including blood loss, serum prostate-specific antigen levels, and the presence or absence of UI. Blood loss was estimated as a decline in postoperative hemoglobina levels. The predictive factors for postoperative UI were determined using a multivariable logistic regression analysis.
  
  
  RESULTS
  Postoperative UI occurred in 31 patients (24.4%), but it cured in 29 patients (93.5%) after a mean duration of 12 weeks. Enucleation time >100 min (p=0.043) and blood loss >2.5g/dL (p=0.032) were identified as significant and independent risk factors for postoperative UI.
  
  
  CONCLUSIONS
  Longer enucleation time and increased blood loss were independent predictors of postoperative UI in patients who underwent HoLEP during the initial learning period. Surgeons in training should take care to perform speedy enucleation maneuver with hemostasis.
authors: Department of Urology, Tama-Nambu Chiiki Hospital, Tokyo, Japan.
authors: Shuichiro
authors: S
authors: Kobayashi
authors: Department of Urology, Tama-Nambu Chiiki Hospital, Tokyo, Japan.
authors: Masataka
authors: M
authors: Yano
authors: Department of Urology, Tama-Nambu Chiiki Hospital, Tokyo, Japan.
authors: Takayuki
authors: T
authors: Nakayama
authors: Department of Urology, Tama-Nambu Chiiki Hospital, Tokyo, Japan.
authors: Satoshi
authors: S
authors: Kitahara
mesh_terms: D000368:Aged; D015992:Body Mass Index; D006695:Holmium; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D059032:Learning Curve; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011184:Postoperative Period; D011467:Prostate / Q000601:surgery*; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000601:surgery*; D012307:Risk Factors; D020728:Transurethral Resection of Prostate / Q000009:adverse effects*; D014549:Urinary Incontinence / Q000209:etiology*
chemical_list: D017430:Prostate-Specific Antigen; D006695:Holmium
keywords: Blood Loss, Surgical; Prostatic Hyperplasia; Urinary Incontinence