Change in postoperative storage symptoms and de novo urge-incontinence after Thulium: YAG laser enucleation of the prostate: results from a prospective, multicenter study.

To assess the change of storage symptoms and their impact on quality of life in men undergoing Thulium: YAG laser enucleation of the prostate (ThuLEP) for benign prostatic hyperplasia (BPH).

BPH patients requiring surgery were prospectively evaluated (April 2019-October 2020).

International Prostate Symptom Score (IPSS) ≥8, maximum urinary flow rate  ≤15 ml/s, and urinary retention.

previous urethral/prostatic surgery, pelvic irradiation, bladder/prostate cancer, neurogenic bladder, concomitant transurethral surgery, and active urinary tract infection. IPSS, International Continence Society-Overactive Bladder (ICIQ-OAB) and International Continence Society-Overactive Bladder Quality of Life (ICIQ-OABq) scores were gathered before surgery and 1,3,6 and 12 months after surgery.

117 men were included. Mean age was 68.0±7.7 years. Mean prostate volume was 86.6±34 cc. Mean IPSS subscore was 8.7±3.1 and 11.7±4.7 for storage and voiding symptoms, respectively. Mean ICIQ-OAB was 29.1±16.8. Mean ICIQ-OABq was 80.3±30.6. Voiding IPSS decreased 72.8% at 1-month, whereas the reduction of storage IPSS was 38.0%. ICIQ-OAB decreased 49.6% at 1-month. ICIQ-OABq showed a 30.0% reduction. One year after surgery, the reduction of voiding IPSS was 94.8%, ICIQ-OAB 85.5%, storage IPSS 76.7%, and ICIQ-OABq 60.5%. Urge-incontinence was present in 26.5% of men at 1-month, 15.4% at 3-month and 4.3% at 6-month. 4(3.4%) patients complained of urge-incontinence 12 months after surgery.

Both storage and voiding LUTS significantly decreased after ThuLEP but storage symptoms showed less reduction with a significant impact on patients' quality of life, particularly during the first 3 months.

Journal of endourology. 2022 Apr 13 [Epub ahead of print]

Daniele Castellani, Mirko Di Rosa, Giovanni Saredi, Andrea Pacchetti, Riccardo Banchero, Francesca Ambrosini, Paola Meroni, Giovanni Guano, Matteo Boltri, Stefano Bucci, Elisa Simonetti, Umberto Maestroni, Stefania Ferretti, Carlo Terrone, Marco Dellabella

AOU Ospedali Riuniti di Ancona, 18494, via conca 71, Ancona, Italy, 60126; ., INRCA-IRCCS, 9345, Ancona, Marche, Italy; ., Ospedale di Circolo e Fondazione Macchi, Urology, Varese, Italy; ., Ospedale di Circolo e Fondazione Macchi, Urology, via Tagliamento 14, Induno Olona, Italy, 21056; ., University of Genoa, 9302, Urology, Genova, Liguria, Italy; ., University of Genoa, 9302, Urology, Genova, Liguria, Italy; ., Ospedale di Circolo e Fondazione Macchi, Urology, Varese, Italy; ., University of Genoa, 9302, Urology, Genova, Liguria, Italy; ., Hospital of Cattinara, 415994, Trieste, Friuli-Venezia Giulia, Italy; ., Trieste, Italy; ., Azienda Ospedaliero-Universitaria di Parma, 18630, Parma, Emilia-Romagna, Italy; ., Hospital and University of Parma, Urology OU, Surgical Department, Parma, Italy; ., Hospital and University of Parma, O.U. Urology, Via Gramsci, n° 14, Parma, Italy, 43100; ., University of Genoa, Urology, Genoa, Italy; ., INRCA-IRCCS, 9345, Ancona, Marche, Italy; .