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"Defining the Drip: A Systematic Review of Incontinence Definitions and Predictors Following HoLEP"
Carl A Ceraolo1, Benedikt M Winzer2, Jason D Fairbourn1
1Department of Urology, University of Rochester Medical Center, Rochester, NY, USA.
Current Urology Reports
|November 3, 2025
Summary
Urinary incontinence after holmium laser enucleation of the prostate (HoLEP) for benign prostatic hyperplasia is influenced by surgical technique. Refining HoLEP procedures is key to improving patient continence outcomes.
Area of Science:
- Urology
- Surgical Innovation
- Patient Outcomes
Background:
- Benign prostatic hyperplasia (BPH) affects a large number of men.
- Holmium laser enucleation of the prostate (HoLEP) is a common BPH treatment.
- Urinary incontinence is a potential complication following HoLEP.
Purpose of the Study:
- To systematically review literature identifying factors contributing to urinary incontinence post-HoLEP.
- To analyze the impact of surgical technique on continence outcomes.
- To highlight areas for improvement in HoLEP procedures and patient care.
Main Methods:
- Systematic literature review of randomized studies.
- Analysis of 40 identified randomized controlled trials.
- Assessment of factors influencing postoperative urinary incontinence.
Main Results:
- Significant heterogeneity in the definition of urinary incontinence across studies.
- Surgical technique identified as a major factor affecting postoperative continence.
- Variability in outcomes suggests a need for standardized approaches.
Conclusions:
- Refinement of holmium laser enucleation of the prostate surgical technique is crucial for improving continence.
- Standardizing definitions of urinary incontinence is necessary for comparative analysis and counseling.
- Further research into surgical, behavioral, and pharmacologic interventions is needed to enhance recovery and quality of life.
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