Acikgoz Onur, Yilmaz Mehmet, Aybal Halil Cagri, Yilmaz Sercan, Gazel Eymen, Yalcin Serdar, Duvarci Mehmet, Kaya Engin, Miernik Arkadiusz, Tunc Lutfi
Department of Urology, Pendik State Hospital, Istanbul, Turkey.
Department of Urology, University of Freiburg-Medical Centre, Faculty of Medicine, Freiburg, Germany.
Cent European J Urol. 2021;74(4):535-540. doi: 10.5173/ceju.2021.0204. Epub 2021 Oct 22.
Diabetes mellitus (DM) is known as a risk factor of stress urinary incontinence after Holmium laser enucleation of the prostate (HoLEP). We aimed to compare the postoperative continence status of patients with and without DM, after HoLEP surgery.
A total of 214 patients who underwent HoLEP between January 2017 and January 2020 were retrospectively assessed. Functional outcomes, perioperative total operation time (TOT)(min), enucleation time (ET)(min), enucleation efficiency (EE)(g/min), enucleated tissue weight (ETW)(g), morcellation efficiency (ME)(g/min), morcellation time (MT)(min), continence status, intraoperative and postoperative complications according to Clavien-Dindo classification were recorded.
A total of 96 patients had DM additional to benign prostate hyperplasia (BPH) (Group 1), while 118 patients had only benign prostate hyperplasia without DM (Group 2). When comparing preoperative and postoperative functional outcomes, a statistically significant improvement was observed in both groups from baseline to the 1 and 6 month follow-up (p ≤0.001). There were no statistically significant differences between groups in postoperative stress urinary incontinence at postoperative months 1 and 6 (1.7% vs 2.1%, p = 1 and 0.8% vs 1%, p = 1; respectively). There was no significant difference between groups in intraoperative and postoperative complications (p >0.05).
HoLEP is safe to perform in patients with DM at low complication and urinary incontinence rates.
糖尿病(DM)是钬激光前列腺剜除术(HoLEP)后压力性尿失禁的一个危险因素。我们旨在比较HoLEP手术后糖尿病患者与非糖尿病患者的术后控尿状态。
回顾性评估了2017年1月至2020年1月期间接受HoLEP手术的214例患者。记录功能结局、围手术期总手术时间(TOT)(分钟)、剜除时间(ET)(分钟)、剜除效率(EE)(克/分钟)、剜除组织重量(ETW)(克)、粉碎效率(ME)(克/分钟)、粉碎时间(MT)(分钟)、控尿状态、根据Clavien-Dindo分类的术中及术后并发症。
共有96例患者除良性前列腺增生(BPH)外还患有糖尿病(第1组),而118例患者仅患有良性前列腺增生而无糖尿病(第2组)。比较术前和术后功能结局时,两组从基线到1个月和6个月随访均观察到有统计学意义的改善(p≤0.001)。术后1个月和6个月时,两组术后压力性尿失禁发生率无统计学差异(分别为1.7%对2.1%,p = 1;0.8%对1%,p = 1)。两组术中及术后并发症无显著差异(p>0.05)。
对于糖尿病患者,HoLEP手术并发症和尿失禁发生率低,是安全可行的。