Comparison of outcomes in patients with and without neurologic diseases undergoing holmium laser enucleation of the prostate

Authors

  • Jenny N. Guo Northwestern University
  • Mark A. Assmus University of Calgary
  • Nicholas S. Dean University of Alberta
  • Matthew S. Lee The Ohio State University
  • Clarissa Wong Northwestern University
  • Jordan Rich Northwestern University
  • Jessica Helon Northwestern University
  • Mitchell M. Huang Northwestern University
  • Amy E. Krambeck Northwestern University

DOI:

https://doi.org/10.5489/cuaj.8683

Keywords:

benign prostatic hyperplasia, HoLEP, neurological disease, urinary tract infection, incontinence

Abstract

Introduction: We aimed to compare holmium laser enucleation of the prostate (HoLEP) outcomes in patients with and without neurologic diseases (ND).

Methods: A prospectively maintained database of patients undergoing HoLEP from January 2021 to April 2022 was reviewed. The following NDs were included: diabetes-related neuropathy/neurogenic bladder, Parkinson’s disease, dementia, cerebrovascular accident, multiple sclerosis, traumatic brain injury, transient ischemic attack, brain/spinal tumors, myasthenia gravis, spinal cord injury, and other. Statistical analysis was performed using t-tests, Chi-squared, and binomial tests (p<0.05).

Results: A total of 118 ND patients were identified with 135 different neurologic diseases. ND patients were more likely to have indwelling catheters (57% vs. 39%, p=0.012) and urinary tract infections (UTIs) preoperatively (32% vs. 19%, p=0.002). Postoperatively, ND patients were more likely to fail initial trial of void (20% vs. 8.1%, p<0.001) and experience an episode of acute urinary retention (16% vs. 8.5%, p=0.024). Within 90 days postoperative, the overall complication rate was higher in the ND group (26% vs. 13%, p=0.001). Within the ND group, 30/118 (25%) had ≥1 UTI within 90 days preoperative, which decreased to 10/118 (8.7%) 90 days postoperative (p<0.001). At last followup (mean 6.7 months [ND] vs. 5.4 months [non-ND], p=0.03), four patients (4.4%) in the ND group required persistent catheter/clean intermittent catheterization compared to none in the non-ND group (p=0.002).

Conclusions: Patients with ND undergoing HoLEP are more likely to experience postoperative retention and higher complication rates compared to non-ND patients. While UTI rates are higher in this population, HoLEP significantly reduced three-month UTI and catheterization rates.

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Published

2024-04-02

How to Cite

Guo, J. N., Assmus, M. A., Dean, N. S., Lee, M. S., Wong, C., Rich, J., Helon, J., Huang, M. M., & Krambeck, A. E. (2024). Comparison of outcomes in patients with and without neurologic diseases undergoing holmium laser enucleation of the prostate . Canadian Urological Association Journal, 18(8). https://doi.org/10.5489/cuaj.8683

Issue

Vol. 18 No. 8 (2024): CUAJ August

Section

Original Research

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