Change of nocturnal polyuria after holmium laser enucleation of the prostate in patients with benign prostatic hyperplasia.

Abstract

OBJECTIVE:

To evaluate changes of nocturnal polyuria (NP) after holmium laser enucleation of the prostate (HoLEP) in patients with nocturia preoperatively.

PATIENTS AND METHODS:

This retrospective study included patients who underwent HoLEP for benign prostatic hyperplasia and recorded 3-day frequency-volume chart strictly. Patients who had a history of prostate cancer, sleep apnea, renal failure, heart failure, or medication of desmopressin were excluded. Nocturia is defined as ≥ 1 void at night, and NP is defined by nocturnal polyuria index (NPI) >33%. Among 472 patients included in the final analysis, 352 men (74.6%) presented nocturia preoperatively. Among those, 205 men (58.2%) who had NP preoperatively were allocated to group NP, and 147 men who did not were allocated to group non-NP.

RESULTS:

In total patients, nocturnal frequency was decreased significantly starting from 3 months after the HoLEP. In NP group, mean value of NPI decreased by 4.1% ± 10.7%, 6.0% ± 9.4%, 6.2% ± 9.5%, and 4.8% ± 11.4% at postoperative months 1, 3, 6, and 12, respectively. The proportion of patients who showed decreased NPI to the normal range (≤ 33%) were 32.5%, 36.1%, 37.7%, and 31.0% at postoperative months 1, 3, 6, and 12, respectively. On receiver operating characteristics curve analysis, an absolute reduction of NPI of ≥ 6.0% was shown as a significant predictor for improved nocturia (≥ 50% reduction of nocturnal frequency).

CONCLUSION:

In our study, the improvement of NP after HoLEP was observed. This suggests that relieving lower urinary tract obstruction has a positive influence on NP, and it could be a new strategy for treatment of NP.

• Authors: Woo Suk Choi, Ja Hyeon Ku, Seung-June Oh, Soo Woong Kim, Jae-Seung Paick
• Journal: Urology (Urology) Vol. 84 Issue 3 Pg. 650-6 (Sep 2014) ISSN: 1527-9995 [Electronic] United States
• PMID: 25168546 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 Elsevier Inc. All rights reserved.

Topics

• Aged
• Humans
• Laser Therapy (methods)
• Lasers, Solid-State
• Male
• Middle Aged
• Nocturia (therapy)
• Preoperative Period
• Prevalence
• Prostate (pathology)
• Prostatic Hyperplasia (surgery)
• ROC Curve
• Retrospective Studies
• Sensitivity and Specificity
• Time Factors
• Urodynamics