Effect of Holmium Laser Enucleation of Prostate on Overactive Bladder Symptoms and Urodynamic Parameters: A Prospective Study
Kwon O1, Lee HE1, Bae J2, Oh JK3, Oh SJ4. Urology. 2013 Dec 24. pii: S0090-4295(13)01386-1. doi: 10.1016/j.urology.2013.10.037. [Epub ahead of print]

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OBJECTIVE: To analyze the effect of Holmium laser enucleation of prostate (HoLEP) on overactive bladder (OAB) symptoms and urodynamic parameters in patients with benign prostatic hyperplasia.

METHODS: One hundred sixty-five patients were included in this prospective study. They complained of lower urinary tract symptoms suggestive of benign prostatic hyperplasia and underwent HoLEP by a surgeon from January 2010 to March 2012. We analyzed the results of International Prostate Symptom Score, overactive bladder questionnaire, frequency-volume chart, and urodynamic studies (UDS) before and after the surgery. Follow-up examinations were repeated 3 and 6 months postoperatively, and a UDS was performed at 6 months after the surgery.

RESULTS: The mean age was 68.4 (range, 52-91) years, the preoperative prostate volume measured by transrectal ultrasound was 71.1 (range, 22-202) mL, and the serum PSA level was 4.4 (range, 0.5-21.7) ng/mL. Postoperatively, patients showed significant improvement in the International Prostate Symptom Score (total score from 20.7 to 5.5, P <.001), overactive bladder questionnaire score (severity score from 24.8 to 12.5, P <.001), and frequency-volume chart parameters (daytime frequency, nocturia, and maximal capacity, respectively) (P <.001). The peak flow rate (P <.001), postvoid residual urine volume (P <.001), maximal cystometric capacity (P <.002), and bladder outlet obstruction index (P <.001) have improved significantly. The number of patients who showed involuntary detrusor contraction in UDS decreased significantly from 45.5% to 36.4% (P <.001). However, bladder compliance did not improve.

CONCLUSION: OAB symptoms and urodynamic parameters were improved significantly after HoLEP surgery in short-term follow-up.