To test for differences in outcomes of lower urinary tract symptoms (LUTS) between patients with and without preoperative indwelling catheter after laser enucleation of the prostate (LEP).
In our tertiary-care database, patients undergoing LEP (11/2017-09/2023) were retrospectively analyzed, stratified by presence of preoperative catheter. Mixed linear models assessed International Prostate Symptom Score (IPSS) and quality of life (QoL) at 1, 3, 12, and 24 months after LEP. Multiple linear regression, adjusted for age and prostate volume, tested for differences in LUTS and QoL recovery.
Among 518 patients, 132 (25%) had a catheter before LEP (89% transurethral, 11% suprapubic), mainly due to acute urinary retention (82%). Mean catheter duration was 13 weeks; 48% exceeded 12 weeks. Catheter patients were older (71 vs. 69 years, p = 0.003), had higher PSA (8.3 vs. 5.8 ng/ml, p < 0.001), and larger prostate volume (98 vs. 86 ml, p = 0.004). At 1 month, catheter patients reported lower IPSS (7.1 vs. 9.8) and more favorable QoL (1.6 vs. 2.3). No significant differences were seen at 3, 12, and 24 months in adjusted IPSS. In regression analyses, preoperative catheter was associated with improved IPSS at 1 (coefficient -2.8, p < 0.001), 3 (-2.6, p < 0.001), and 12 months (-1.8, p = 0.007), as well as better QoL at 1 (beta -0.8, p < 0.001), 3 (-0.7, p < 0.001), and 12 months (-0.4, p = 0.01).
Patients with preoperative catheterization appear to experience similar long-term benefits from LEP compared to those without catheter, but show greater improvements in LUTS and QoL within the first postoperative year.
International urology and nephrology. 2025 Dec 25 [Epub ahead of print]
Cristina Cano Garcia, Fiona Schlesinger, Pia Bongardt, Maria Welte, Maximilian Filzmayer, Clara Humke, Luis A Kluth, Philipp Mandel, Matthias Müller, Miriam Traumann, Felix K H Chun, Andreas Becker, Marina Kosiba
Department of Urology, Goethe University Frankfurt, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany. ., Department of Urology, Goethe University Frankfurt, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany., Urologisches Zentrum Am Boxberg, Neunkirchen, Germany.