title: Predictors of urgency improvement after Holmium laser enucleation of the prostate in men with benign prostatic hyperplasia.
abstract: To investigate the change in urinary urgency and predictors of urgency improvement after holmium laser enucleation of the prostate (HoLEP) in men with benign prostatic hyperplasia (BPH).
  
  
  
  We retrospectively analyzed the medical records of patients who were treated with HoLEP for BPH and had preoperative urgency measuring ≥3 on a 5-point urinary sensation scale. Those with prostate cancer diagnosed prior to or after HoLEP, a history of other prostatic and/or urethral surgery, moderate to severe postoperative complications, and neurogenic causes were excluded. Patients who had improved urgency with antimuscarinic medication after HoLEP were excluded. We divided the patients into 2 groups based on urgency symptoms 3 months after HoLEP: improved and unimproved urgency. Improved urgency was defined as a reduction of 2 or more points on the 5-point urinary sensation scale. Preoperative clinical and urodynamic factors as well as perioperative factors were compared between groups.
  
  
  
  In total, 139 patients were included in this study. Voiding parameters in all patients improved significantly after HoLEP. Seventy-one patients (51.1%) had improved urgency, while 68 (48.9%) did not show any improvement. A history of acute urinary retention (AUR) and postvoid residual were associated with postoperative urgency improvement in univariate analysis. In multivariate analysis, a history of AUR was an independent factor affecting urgency improvement.
  
  
  
  A preoperative history of AUR could influence the change in urgency after HoLEP surgery in patients with BPH.
authors.affiliation: Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Won Sok
authors.initials: WS
authors.lastname: Hur
authors.affiliation: Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Joon Chul
authors.initials: JC
authors.lastname: Kim
authors.affiliation: Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Hyo Sin
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Jun Sung
authors.initials: JS
authors.lastname: Koh
authors.affiliation: Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Hyun Woo
authors.initials: HW
authors.lastname: Kim
authors.affiliation: Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Su Yeon
authors.initials: SY
authors.lastname: Cho
authors.affiliation: Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Kang Jun
authors.initials: KJ
authors.lastname: Cho
mesh_terms: D000368:Aged; D006695:Holmium; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011470:Prostatic Hyperplasia / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D011594:Psychometrics; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D016055:Urinary Retention / Q000209:etiology / Q000601:surgery; D014563:Urodynamics
chemical_list: D006695:Holmium
keywords: Holmium; Laser therapy; Overactive urinary bladder; Prostatic hyperplasia