Correlation between prostate volume and postoperative stress urinary incontinence after holmium laser enucleation of the prostate in the elderly benign prostatic hyperplasia patients

Objective To investigate the relationship between prostate volume and postoperative stress urinary incontinence (SUI) in the elderly benign prostatic hyperplasia (BPH) patients following holmium laser enucleation of the prostate (HoLEP). Methods A retrospective analysis was performed on clinical data of 110 elderly (age ≥ 60 years) BPH patients who underwent HoLEP in Grand Hospital of Jincheng in Shanxi between 2014 and 2018. In these patients, preoperative transrectal ultrasonography revealed that the prostate volume was 21-198(74.53 ± 31.26) ml. According to prostate volume, the patients were allocated to large prostate volume group (prostate volume ≥ 80 ml), intermediate prostate volume group (40 ml < prostate volume < 80 ml) and small prostate volume group (prostate volume ≤ 40 ml). All patients underwent the HoLEP, the incidence of postoperative SUI was compared among the three groups after withdrawal of stenting catheters. Results After HoLEP, 74 patients were uneventful, while 36 patients experienced the postoperative SUI. No perpetual SUI patient was found after follow-up for 1 week to 6 months. The incidence of postoperative SUI after HoLEP was positively correlated with prostate volume (r=0.331, P < 0.05). The 36 elderly BPH patients with postoperative SUI accounted for 51.35%(19/37), 33.33% (12/36) and 13.51% (5/37), respectively in large, intermediate and small prostate volume groups, with statistically significant difference among three groups after Kruskal-Walls test (χ2= 11.930, P < 0.05). Conclusions The incidence of postoperative stress urinary incontinence after HoLEP of the prostate is positively correlated with prostate volume in the elderly BPH patients. Key words: Prostatic hyperplasia; Holmium laser; Enucleation of the prostate; Urinary incontinence