Research fellow Baylor Scott & White Health; Alexandria University Faculty of Medicine, Egypt
Introduction: Irritative urinary symptoms and urinary tract infection (UTI) are among the most common complications following Holmium Laser Enucleation of Prostate (HoLEP). We aimed to study the incidence and risk factors for early irritative urinary symptoms and postoperative UTI post-HoLEP. Methods: A maintained HoLEP database of over 5 years at our institution was reviewed. Patients' demographics, perioperative characteristics, post-operative irritative symptoms, and UTI rates (defined by irritative symptoms with positive urine culture) were analyzed. Results: Total 473 patients with complete follow-up data were included. Tables [1] and [2] show the baseline and postoperative data of included patients respectively. Preoperative positive urine culture and urine retention were seen in 128 (27%) and 111 (23.4%) patients respectively. At 6-week follow-up, irritative urinary symptoms were reported by 153 (32.3%) patients, while urine culture was positive in only 64 (13.5%) patients. Multivariate analysis showed that high body mass index (BMI) (HR= 2.02; CI= 1.36-2.58, p = 0.023), weak grip strength within preoperative frailty assessment (HR= 1.36; CI =1.06-2.13, p=0.042), preoperative positive urine culture (HR= 1.92; CI= 1.3-3.38, p= 0.025) and postoperative incontinence (HR= 2.82; CI= 1.8-5.67, p = 0.002) were associated with statistically significant risk of positive urine within 1st 6 weeks post-HoLEP. Conclusions: Irritative urinary symptoms are common complaints post-HoLEP; however, it may be caused by inflammatory rather than infective process in significant percentage of patients. Irritative Symptoms can be associated with over-treatment with empirical antibiotics. Possible predictors of early UTI post-HoLEP are high BMI, preoperative positive urine culture, higher frailty scale, and postoperative urinary incontinence. SOURCE OF Funding: None
