HoLEP術後1年目までの尿失禁・性機能の推移

Abstract

We performed holmium laser enucleation of the prostate (HoLEP) on 98 patients between February 2005 and February 2007. Seventy five patients with the mean age of 68.9 (ranging 55-84) were assessed preoperatively and followed up at 1, 3 and 12 months postoperatively. Before and after HoLEP, International Prostate Symptom Score (IPSS), quality of life (QOL) index, maximum flow rate (Qmax) and post-void residual (PVR) urine were all improved significantly (P or = 1, incontinence was observed in 71% of patients preoperatively. ICIQ-SF scores were increased from 5.2 preoperatively to 8.0 at 1 month postoperatively, but improved thereafter and had decreased significantly to 2.5 (p < 0.05 compared with baseline) at 12 months. Univariate and multivariate logistic regression analysis revealed date of operation and operation time were significantly (P < 0.05) correlated with postoperative stress urinary incontinence (SUI) at 1 month and enucleated volume was of borderline significance (p = 0.052) at 12 months. In terms of sexual function, mean IIEF5 scores were not significantly changed, but we could classify the scores into five types of response-unchanging (64%), improving (13%), worsening (11%), transient worsening (9%) and unclassified (2%). HoLEP is an effective treatment for BPH. Urinary incontinence improved by 1 year. HoLEP does not appear to affect sexual function, but various clinical courses were observed.