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KMID : 1011820160570060431
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Investigative and Clinical Urology
2016 Volume.57 No. 6 p.431 ~ p.436
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Predictors of urgency improvement after Holmium laser enucleation of the prostate in men with benign prostatic hyperplasia
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Hur Won-Sok
Kim Joon-Chul
Kim Hyo-Sin
Koh Jun-Sung
Kim Sang-Hoon
Kim Hyun-Woo
Cho Su-Yeon
Cho Kang-Jun
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Abstract
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Purpose: To investigate the change in urinary urgency and predictors of urgency improvement after holmium laser enucleation of the prostate (HoLEP) in men with benign prostatic hyperplasia (BPH).
Materials and Methods: We retrospectively analyzed the medical records of patients who were treated with HoLEP for BPH and had preoperative urgency measuring ≥3 on a 5-point urinary sensation scale. Those with prostate cancer diagnosed prior to or after HoLEP, a history of other prostatic and/or urethral surgery, moderate to severe postoperative complications, and neurogenic causes were excluded. Patients who had improved urgency with antimuscarinic medication after HoLEP were excluded. We divided the patients into 2 groups based on urgency symptoms 3 months after HoLEP: improved and unimproved urgency. Improved urgency was defined as a reduction of 2 or more points on the 5-point urinary sensation scale. Preoperative clinical and urodynamic factors as well as perioperative factors were compared between groups.
Results: In total, 139 patients were included in this study. Voiding parameters in all patients improved significantly after HoLEP. Seventy-one patients (51.1%) had improved urgency, while 68 (48.9%) did not show any improvement. A history of acute urinary retention (AUR) and postvoid residual were associated with postoperative urgency improvement in univariate analysis. In multivariate analysis, a history of AUR was an independent factor affecting urgency improvement.
Conclusions: A preoperative history of AUR could influence the change in urgency after HoLEP surgery in patients with BPH.
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KEYWORD
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Holmium, Laser therapy, Overactive urinary bladder, Prostatic hyperplasia
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