Modified early apical release vs. non-early apical release in holmium laser prostatic enucleation: Impact on stress urinary incontinence
Abstract
INTRODUCTION
We aimed to compare the incidence of de novo stress urinary incontinence (SUI) of two apical release techniques for holmium laser prostatic enucleation (HoLEP)s: modified early apical release (EAR) and non-early apical release (non-EAR).
METHODS
We conducted a retrospective database review analyzing the records of patients who underwent holmium laser enucleation of the prostate with the modified EAR and non-EAR techniques for symptomatic benign prostatic hyperplasia. The study period spanned from January 2012 to December 2021 in a single center. Patients' demographics, perioperative data, and functional and technical outcomes were compared between both techniques.
RESULTS
The study included a total of 786 patients; 556 patients underwent the non-EAR technique (group I), and 230 underwent the modified EAR technique (group II). The mean enucleated prostate weight in group I was 68.2±45.6 g compared to 93.3±51.9 g in group II (p70 years (p=0.06), operative time >90 minutes (p=0.011), and the non-EAR technique (p=0.004) were significantly associated with the onset of postoperative de novo SUI.
CONCLUSIONS
Our research indicates that both modified EAR and non-EAR techniques employed during HoLEP yield comparable efficacy and safety outcomes. Nonetheless, the modified EAR technique is associated with reduced postoperative de novo SUI.
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