Objective: Patients can experience urinary retention (UR) after Holmium laser enucleation of the prostate (HoLEP) that\r\nrequires bladder distension during the procedure. The aim of this retrospective study is to identify factors affecting the UR\r\nafter HoLEP.\r\nMaterials and Methods: 336 patients, which underwent HoLEP for a symptomatic benign prostatic hyperplasia between\r\nJuly 2008 and March 2012, were included in this study. Urethral catheters were routinely removed one or two days after\r\nsurgery. UR was defined as the need for an indwelling catheter placement following a failure to void after catheter removal.\r\nDemographic and clinical parameters were compared between the UR (n = 37) and the non-urinary retention (non-UR;\r\nn = 299) groups.\r\nResults: The mean age of patients was 68.3 (66.5) years and the mean operative time was 75.3 (637.4) min. Thirty seven\r\npatients (11.0%) experienced a postoperative UR. UR patients voided catheter free an average of 1.9 (61.7) days after UR.\r\nWith regard to the causes of UR, 24 (7.1%) and 13 (3.9%) patients experienced a blood clot-related UR and a non-clot related\r\nUR respectively. Using multivariate analysis (p,0.05), we found significant differences between the UR and the non-UR\r\ngroups with regard to a morcellation efficiency (OR 0.701, 95% CI 0.498ââ?¬â??0.988) and a bleeding-related complication, such as,\r\na reoperation for bleeding (OR 0.039, 95% CI 0.004ââ?¬â??0.383) or a transfusion (OR 0.144, 95% CI 0.027ââ?¬â??0.877). Age, history of\r\ndiabetes, prostate volume, pre-operative post-void residual, bladder contractility index, learning curve, and operative time\r\nwere not significantly associated with the UR (p.0.05).\r\nConclusions: De novo UR after HoLEP was found to be self-limited and it was not related to learning curve, patient age,\r\ndiabetes, or operative time. Efficient morcellation and careful control of bleeding, which reduces clot formation, decrease\r\nthe risk of UR after HoLEP.
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