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Updated: Jan 30, 2026

Surgical Treatment for Benign Prostatic Hyperplasia: Holmium Laser Enucleation of the Prostate HoLEP.
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[Urinary incontinence after HOLEP: Incidence, evolution and predictive factors].

J Sapetti1, J Sakat1, E Saad1

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|January 22, 2019
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Summary

Urinary incontinence affects over 40% of patients one month after Holmium Laser Enucleation of the Prostate (HoLEP) for benign prostatic hypertrophy, with stress incontinence being most common. Energy delivered and preoperative IIEF5 scores predict this complication.

Keywords:
IncontinenceLaserProstate

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Area of Science:

  • Urology
  • Surgical Innovation
  • Patient Outcomes

Background:

  • Benign prostatic hypertrophy (BPH) is a common condition requiring surgical intervention.
  • Holmium Laser Enucleation of the Prostate (HoLEP) is an effective BPH treatment.
  • Early morbidity, particularly urinary incontinence, after HoLEP requires further investigation.

Purpose of the Study:

  • To assess early morbidity following HoLEP surgery.
  • To specifically evaluate the incidence, types, and evolution of urinary incontinence post-HoLEP.
  • To identify predictive factors for postoperative urinary incontinence.

Main Methods:

  • An observational, analytical, retrospective, monocentric study was conducted.
  • 171 patients undergoing HoLEP for BPH between November 2015 and January 2017 were included.
  • Data collection included pre-, peri-, and postoperative parameters with a 6-month follow-up.

Main Results:

  • 14.6% of patients experienced complications (Clavien-Dindo classification).
  • Urinary incontinence was present in 42.7% at 1 month, predominantly stress incontinence (86.1%).
  • At 6 months, 32.7% remained incontinent; delivered energy and preoperative IIEF5 score predicted stress incontinence.

Conclusions:

  • Urinary incontinence is a notable early complication after HoLEP.
  • The surgical technique may influence incontinence rates.
  • Informing patients about the risk of postoperative incontinence is essential.