Acute urinary retention is one of the indication of prostate surgey in benign prostate hyperplasia(BPH). The purpose of this study was to investigate the effect of previous history of acute urinary retention on result of HoLEP.

The patients who had performed HoLEP for LUTS/BPH at three different hospitals from March 2013 to May 2017 were included in this study. perioperative variables was analyzed retrospective method in electronic medical. All patients was analyzed the baseline characteristics, physical examination, TRUS, PSA, comorbidity, preoperative/postoperative uroflowmetry with post-voiding residual volume, IPSS questionnaire, and operative parameter.

Total 486 patients were included in this study. Within 486 patients, 150 patients had history of acute urinary retention(AUR group) and 336 patients did not.(retention group). There were no significant difference in Mean ages and mean prostate volume, PSA level, and prostate volume. In preoperative uroflowmetry parameter, AUR group was presented lower voiding volume and PVR were identified compared to retention group. In preoperative IPSS questionnaire, intermittency and QoL were higher and lower in total score in AUR group. During operation, higher energy(130.6J vs. 103.5J), energy efficacy(0.651 vs. 0.461), time-resection efficacy(0.526 vs. 0.409), enucleation efficacy(0.669 vs. 0.501) and morcellation efficacy(3.98 vs. 3.27) One month after operation, residual urine, intermittency, weak stream, voiding score, storage score and total score in IPSS were lower in AUR group.

Acute urinary incontinence causes severe discomfort due to the patient, which often causes moderate urination symptoms before acute urinary retention. This can dramatically improve the symptoms of voiding due to the elimination of bladder outlet obstruction after surgery, which may improve symptoms and improve clinical indices. Congestion and transient inflammatory tissue changes are thought to cause more energy use and bleeding.

In acute urinary retention, symptom improvement after operation was superior than non-retention patients. But higher energy use and transfusion risk is identified. So urologists recommend the operation easily because history of AUR patients expected better efficacy and patient’s satisfaction.