Metabolic syndrome is predictive of lower urinary tract symptom improvement after holmium laser enucleation of the prostate for benign prostatic obstruction.

PURPOSE

To investigate the effect of metabolic syndrome (MS) on patient outcomes who underwent holmium laser enucleation of the prostate (HoLEP) for benign prostatic obstruction.

MATERIALS AND METHODS

Data from 151 patients who underwent HoLEP by a single surgeon between March 2012 and March 2016 were retrospectively analyzed. Patients with MS were assigned to group 1 (n = 33) and patients without MS in group 2 (n = 118). Clinical characteristics and the International Prostate Symptom Score (IPSS), including quality of life (QoL), peak urinary flow rate (Qmax), and postvoid residual urine (PVR), before surgery and 3 months afterward were compared between groups. Additionally, predictors of total IPSS improvement after HoLEP were assessed.

RESULTS

Compared with group 2 patients, group 1 patients were older (70.3 vs. 65.2 years old, p = 0.001). Preoperative data, which included prostate volume, QoL, Qmax, and PVR, were not different between groups. For all patients, both the storage subscore and voiding subscore significantly decreased after surgery (p < 0.001). Postoperative total IPSS and voiding subscore improvement in group 1 were lower than in group 2 (total IPSS improvement 9.2 vs. 12.5, p = 0.042; voiding subscore improvement 6.6 vs. 8.8, p = 0.048). Multivariate analysis showed preoperative total IPSS (β = 0.79, CI 0.71-0.94, p < 0.001) and number of MS components (β = -0.15, CI -2.04 to -0.29, p = 0.009) were independently associated with total IPSS improvement.

CONCLUSIONS

We found that MS was associated with decreased postoperative symptom improvement. Thus, lower urinary tract symptoms after surgery may be a systemic disorder due to multiple metabolic risk factors.