Change of nocturnal polyuria after holmium laser enucleation of the prostate in patients with benign prostatic hyperplasia.

OBJECTIVE

To evaluate changes of nocturnal polyuria (NP) after holmium laser enucleation of the prostate (HoLEP) in patients with nocturia preoperatively.

PATIENTS AND METHODS

This retrospective study included patients who underwent HoLEP for benign prostatic hyperplasia and recorded 3-day frequency-volume chart strictly. Patients who had a history of prostate cancer, sleep apnea, renal failure, heart failure, or medication of desmopressin were excluded. Nocturia is defined as ≥ 1 void at night, and NP is defined by nocturnal polyuria index (NPI) >33%. Among 472 patients included in the final analysis, 352 men (74.6%) presented nocturia preoperatively. Among those, 205 men (58.2%) who had NP preoperatively were allocated to group NP, and 147 men who did not were allocated to group non-NP.

RESULTS

In total patients, nocturnal frequency was decreased significantly starting from 3 months after the HoLEP. In NP group, mean value of NPI decreased by 4.1% ± 10.7%, 6.0% ± 9.4%, 6.2% ± 9.5%, and 4.8% ± 11.4% at postoperative months 1, 3, 6, and 12, respectively. The proportion of patients who showed decreased NPI to the normal range (≤ 33%) were 32.5%, 36.1%, 37.7%, and 31.0% at postoperative months 1, 3, 6, and 12, respectively. On receiver operating characteristics curve analysis, an absolute reduction of NPI of ≥ 6.0% was shown as a significant predictor for improved nocturia (≥ 50% reduction of nocturnal frequency).

CONCLUSION

In our study, the improvement of NP after HoLEP was observed. This suggests that relieving lower urinary tract obstruction has a positive influence on NP, and it could be a new strategy for treatment of NP.