Effect of Holmium Laser Enucleation of Prostate on Overactive Bladder Symptoms and Urodynamic Parameters: A Prospective Study

Abstract

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. (C) 2014 Elsevier Inc.