Introduction: After the end of the learning curve, dysuria currently represents the main problem after endoscopic enucleation of the prostate with Holmium Laser (HoLEP). So far, no analysis has actively evaluated its occurrence in the first postoperative weeks and the literature is scarce in defining its risk factors. To evaluate the incidence of dysuria in the first weeks after HoLEP and the main risk factors involved. Methods: We performed a prospective cohort study with patients diagnosed with benign prostatic hyperplasia (BPH) and undergoing HoLEP. The surgeries were performed by a high skilled surgeon in the method. The occurrence of dysuria was actively evaluated using a Likert scale, where scores from 0 to 3 were classified as mild dysuria and scores from 4 to 10 as moderate to severe dysuria. Patients were assessed weekly. For the analysis of risk factors, we selected 6 categorical clinical variables and 14 continuous clinical variables. For the analysis of categorical variables, we used Fisher's exact and Chi-square tests. For analysis of continuous variables, we used Student's and Mann-Whitney's t tests. The homogeneity of the samples was evaluated using the Levene test. For statistical significance we considered a p < 0.05. Results: To date, 23 patients have reached a sufficient follow-up period for the study. The prevalence of moderate to severe dysuria was 66.7% in the first week and 33.3% in the fourth week (figure). In the first week, no variable was relevant in the occurrence of dysuria. At week four, the mean age among patients with moderate to severe dysuria was statistically lower (62.5 vs 68.4 years; p = 0.02), and the prevalence of moderate to severe dysuria was statistically higher among patients with a history of preoperative prostate biopsy (66.7% vs 14.3%, p = 0.037). Symptom score, prostatic volume, energy density used, surgical time, use of Moses technology, among others, were not related to the intensity of dysuria (table). Conclusions: When actively and early evaluated, the prevalence of moderate to severe dysuria is significant in the first weeks after HoLEP. Younger patients and cases with a history of prostate biopsy have higher rates of dysuria in the fourth postoperative week. SOURCE OF Funding: None
