Anterior depth of prostate: Morphological factor associated with de novo urinary incontinence following holmium laser enucleation of the prostate

Kim J1

Research Type


Abstract Category

Male Stress Urinary Incontinence (Post Prostatectomy Incontinence)

Abstract 287
Male Stress Urinary Incontinence
Scientific Podium Short Oral Session 17
Thursday 5th September 2019
10:37 - 10:45
Hall G1
Incontinence Benign Prostatic Hyperplasia (BPH) Surgery
1.Department of Urology, Kwangju Christian Hospital, Gwangju, Korea

Jun Seok Kim



Hypothesis / aims of study
Transient urinary incontinence may occur in up to 44% of patients after holmium laser enucleation of the prostate (HoLEP). However, there are few published data concerning the factors associated with de novo urinary incontinence (UI). The aim of this study was to investigate whether morphological characteristics of prostate are associated with de novo UI after HoLEP.
Study design, materials and methods
Our study included 223 patients who underwent HoLEP. Morphological characteristics of prostate was estimated by a trans-rectal ultrasonography (TRUS) such as size, width, depth, longitudinal diameter, presence of intravesical prostatic protrusion, posterior depth, and anterior depth. Anterior depth of prostate was defined as a diameter from prostate urethra to anterior prostate capsule on a sagittal plane of TRUS. Enrolled patients were divided into two groups according to the presence of UI. Independent t test was used to compare between two groups. Logistic regression analysis was performed to investigate a correlation with de novo UI.
After HoLEP, 68 patients (30.4%) had de novo UI, most of them resolved within 1-6 months. Age and anterior depth of prostate were significantly higher in UI group than non-UI group (76.07 ± 5.82 vs 72.01 ± 8.04 years; P = 0.007, 18.61 ± 3.89 vs 11.84 ± 3.70 mm, P < 0.001). There were no significant differences in the other morphological characteristics, prostate volume, retrieved tissue weight, and operative time between two groups. In a logistic linear regression analysis, only anterior depth of prostate was an independent predictor of de novo UI after HoLEP.
Interpretation of results
About one-third of patients might undergo de novo UI following HoLEP, and most of them might have been resolved within 1-6 months. Thick anterior depth of prostate is associated with de novo UI after HoLEP
Concluding message
Anterior depth of prostate on TRUS could be used as a practical tool to predict postoperative de novo UI.
Figure 1
Funding none Clinical Trial No Subjects Human Ethics not Req'd this study is a retrospective study. Helsinki Yes Informed Consent No