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• W3182094184 abstract "You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology II (MP09)1 Sep 2021MP09-15 PREOPERATIVE DRIVERS OF PERSISTENT/RECURRING LOWER URINARY TRACT SYNDROMS (LUTS) AFTER HOLMIUM LASER ENUCLEATION OF THE PROSTATE (HOLEP)—REPORT FROM A SINGLE CENTER COHORT OF 902 PATIENTS WITH LONG-TERM FOLLOW-UP Philipp Gild, Malte Vetterlein, Tim Ludwig, Armin Soave, Philip Marks, Roland Dahlem, Margit Fisch, Michael Rink, Andreas Becker, and Christian Meyer Philipp GildPhilipp Gild More articles by this author , Malte VetterleinMalte Vetterlein More articles by this author , Tim LudwigTim Ludwig More articles by this author , Armin SoaveArmin Soave More articles by this author , Philip MarksPhilip Marks More articles by this author , Roland DahlemRoland Dahlem More articles by this author , Margit FischMargit Fisch More articles by this author , Michael RinkMichael Rink More articles by this author , Andreas BeckerAndreas Becker More articles by this author , and Christian MeyerChristian Meyer More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001982.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Aside the existing level-one evidence, few centers have reported on long-term outcomes after Holmium Laser Enucleation of the Prostate (HoLEP). Against this backdrop we aimed to report on our decade long experience and identify preoperative predictors of persistent/recurrent lower urinary tract syndroms (LUTS) after the procedure. METHODS: We retrospectively reviewed 2,566 men undergoing HoLEP between 2006-2017. Only patients with available, cross-sectional follow-up ≥6 months were included. Perioperative and follow-up (F/u) characteristics were compared according to duration of F/u in months (quartiles). Multivariable logistic regression models were employed to identify predictors of persistent/recurring symptoms, defined as International Prostate Score (IPSS) >7 at F/u. RESULTS: Our study cohort consisted of 902 patients with a median age of 71 years (interquartile range (IQR) 66-75), prostate volume of 80 ml (IQR 59-105), ASA score 2 (IQR 2-3), IPSS of 19 (IQR 14-23) and Quality of Life (QoL) of 4 (3-5) at the time of surgery. At a median follow-up of 51 months (IQR 31-78) the overall current PSA was 0.92 mg/dl (0.5-1.8), IPSS and QoL were 3 (IQR 1-7) and 1 (IQR 0-2), respectively. Persistent/recurring symptoms were present in 168 (19%) of patients. LUTS medication including anticholinergics and alphablockers were present in 23 patients (2.6%), whereas 9 patients (1%) had an indwelling catheter. 19 (1.9%) of patients required reoperation, permanent urinary incontinence was present in 20 (2.2%) of patients. Stratification by duration of follow-up (1st, 2nd, 3rd, 4th quartile 6-31 months, 32-51 months, 52-78 months, 79-124 months, respectively) revealed significant differences with respect to QoL (1 (IQR 0-1) vs. 1 (IQR 1-2)) and any permanent urinary incontinence (4 patients (1.8%) vs. 7 patients (3.1%)) in the 1st vs. 4th follow-up quartile. No significant differences were observed with respect to PSA, IPSS, LUTS medication, presence of an indwelling catheter, or rates of resurgery (all p>0.1). In multivariable analysis age at surgery (odds ratio (OR) 1.04 (95% Confidence Interval (CI) 1.01-1.07), p=0.003), prostate volume (OR 0.99 (95%CI 0.98-0.99), p=0.029), BMI (OR 1.06 (95%CI 1.0-1.1), p=0.035), presence of indwelling catheter prior to surgery (OR 0.51 (95%CI 0.32-0.82), p=0.003), and anticholinergic medication prior to surgery (OR 1.74 (95%CI 1.01-3.0), p=0.003) were independent predictors of persistent/recurring symptoms. CONCLUSIONS: Our experience confirms overall durable and excellent outcomes after HoLEP. Yet, a non-negligible fraction of patients with persistent/recurring LUTS highlights the need for optimizing patient selection and utilizing individualized treatments among the growing armamentarium of surgical options. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e165-e166 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Philipp Gild More articles by this author Malte Vetterlein More articles by this author Tim Ludwig More articles by this author Armin Soave More articles by this author Philip Marks More articles by this author Roland Dahlem More articles by this author Margit Fisch More articles by this author Michael Rink More articles by this author Andreas Becker More articles by this author Christian Meyer More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W3182094184 title "MP09-15 PREOPERATIVE DRIVERS OF PERSISTENT/RECURRING LOWER URINARY TRACT SYNDROMS (LUTS) AFTER HOLMIUM LASER ENUCLEATION OF THE PROSTATE (HOLEP)—REPORT FROM A SINGLE CENTER COHORT OF 902 PATIENTS WITH LONG-TERM FOLLOW-UP" @default.
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