Application value of Ω-shaped functional urethra preservation in reducing urinary incontinence after holmium laser prostate enucleation in elderly patients
Objective To investigate the improvement in postoperative stress urinary inconti-nence(SUI)following Ω-shaped functional urethra preservation in holmium laser enucleation of the prostate(HoLEP).Methods Clinical data from 160 patients with hyperplasia of prostate aged ≥ 80 years who underwent HoLEP treatment in our hospital between November 2021 and November 2022 were retrospectively analyzed.The patients received partial urethral mucosa preservation(group A,80 cases)and Ω-shaped functional urethra preservation(group B,80 cases).Intraoperative and postop-erative parameters were recorded.Evaluation of urinary incontinence status and voiding symptoms was performed.Results There were no significant differences in prostate-specific antigen(PSA),prostate volume,International Prostate Symptom Score(IPSS),quality of life(QOL)score,maximum urinary flow rate(Qmax),residual urine volume(PVR),operation time,enunciation weight,and hemoglobin(Hb)decline between 2 groups(all P＞0.05).Regarding postoperative urinary incontinence,the immediate post-catheter removal urinary incontinence rate was 23.8％(19/80)in group A and 3.8％(3/80)in group B,with group B significantly lower than group A(P＜0.05).At 2 weeks and 1 month after surgery,the incidence of stress incontinence in group A was 12.5％(10/80)and 7.5％(6/80),respectively,while that in group B was 0.The incidence of stress incontinence in group B was significantly lower than that in group A(all P＜0.05).Three months after surgery,the incidence of stress incontinence was 5.0％(4/80)in group A and 0 in group B,but there was no statistically significant difference between the two groups(P＞0.05).Conclusions Compared to preserving only the urethral mucosa,HoLEP with preserved functional urethra significantly reduces the occurrence of early postoperative stress urinary incontinence in elderly patients.
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