Feasibility of anterior lobe-preserving transurethral enucleation and resection of prostate on improving urinary incontinence in patients with benign prostatic hyperplasia: A retrospective cohort study

Abstract

Transurethral enucleation and resection of prostate (TUERP), as one of the conventional surgical methods for patients with benign prostatic hyperplasia (BPH), usually resulted in pseudo urinary incontinence after surgery. The present study was thereby conducted to evaluate the feasibility of anterior lobe-preserving transurethral enucleation and resection of prostate (ALP-TUERP) on reducing the incidence rate of urinary incontinence after surgery in patients with BPH. Patients diagnosed with BPH underwent surgical treatment were enrolled in the present study within the inclusion criteria. Characteristics including age, prostate volume (before surgery), PSA level, maximum free flow rate, international prostate symptom score, and quality of life were reviewed and compared between the groups of ALP-TUERP and TUERP. Incidence rate of urinary incontinence on 24 hours, 3 days, 7 days, and 14 days after catheter drawing was deemed as main outcome, which was compared between the groups. In addition, secondary outcomes including surgery time, difference value of hemoglobin before and after surgery (∆Hemoglobin), catheter retaining time, catheter flushing time, and incidence rate of recurrent bleeding were also compared between the groups. There were 81 patients included in the present study within the inclusion criteria. There was no statistical difference on the baseline characteristics including age, prostate volume (before surgery), PSA level, maximum free flow rate (before surgery), international prostate symptom score, or quality of life between the 2 groups. Statistical superiority was observed on the incidence rate of urinary incontinence on day 1 (χ 2 = 9.375, P = .002), and day 3 (χ 2 = 4.046, P = .044) in the group ALP-TUERP, when comparing to group TUERP. However, the difference was not observed anymore after 7 days after catheter drawing (P = .241 for day 7, P = .494 for day 14) between them. In addition, no statistical differences were observed on surgery time, difference value of hemoglobin before and after surgery (∆Hemoglobin), catheter retaining time, or catheter flushing time between the group ALP-TUERP and TUERP (all P > .05). Results of the present study demonstrated a potentially statistical superiority of ALP-TUERP on the reduction of incidence rate of urinary incontinence comparing to conventionally TUERP.