Presentation Authors: Zhang Fan*, Liu Ke, Zhang Shudong, Xiao Chunlei, Huang Yi, Ma Lulin, Beijing, China, People's Republic of
Introduction: To assess whether recovery of urinary continence after holmium laser enucleation of the prostate (HoLEP) is associated with membranous urethral length on preoperative magnetic resonance imaging.
Methods: From Jan. 2016 to Mar. 2018, there were 126 patients underwent HoLEP in our hospital because of LUTs caused by BPH. All the procedures were performed by a single surgeon with more than 200 HoLEP experience(Prof. Xiao). Perioperative data were recorded including PSA, IPSS score, volume measured by ultrasound, operation time and estimated blood loss. The membranous urethral length (MUL) was measured on coronal magnetic resonance imaging (MRI) images of each patient and was defined as the distance from the prostatic apex to the entry of the urethra into the penile bulb. The recovery of urinary continence was recorded postoperatively, during an 8 weeks follow up.
Results: The mean MUL of the 126 patients measured on preoperative MRI was 14(9ï¼22)mm. The continent rate of 2, 4, 8 weeks postoperatively were 81.0%, 89.7%, and 96.6%, respectively. The patients were divided into two groups according to MUL measured on preoperative MRI with the cutoff 14mm. There was significant difference between group A (MULï¼œ14mm) and group B (MULâ‰¥14mm) with respect to continent rate of 2 and 4 weeks after surgery, which were 76.7% in group A versus 85.6% in group B (P=0.036); and 87.1% in group A versus 96.3% in group B (P=0.016), respectively. Whereas the continent rate of 8 weeks after surgery were 93.5% in group A versus 100% in group B. There was no significant difference between two groups (P=0.179).
Conclusions: Short MUL, which is less than 14mm, is significantly associated with delayed recovery of urinary continence after HoLEP in terms of continent rate, especially in early stage (1 month) after the procedure.