[Effect of modified holmium laser enucleation of the prostate on postoperative urinary control and sexual function in elderly patients with benign prostatic hyperplasia].

ABSTRACT

OBJECTIVE: To investigate the impact of retaining part of the urethral mucosa on postoperative urinary control, erectile function, and ejaculatory function in patients undergoing holmium laser enucleation of the prostate (HoLEP) surgery. METHODS: A retrospective analysis was conducted on 176 benign prostatic hyperplasia (BPH) patients who underwent surgical treatment at our hospital from January 2019 to January 2022, including 80 cases of modified HoLEP surgery and 96 cases of standard HoLEP surgery. Preoperative and postoperative clinical data were collected and analyzed. RESULTS: At 3 months postoperatively, both groups showed significant improvement in maximum flow rate (Qmax), International Prostate Symptom Score (IPSS) , residual urine volume (RUV) , and quality of life (QOL) compared to pre-treatment values, with statistically significant differences (P<0.05) . There was a significant difference in QOL scores between the experimental and control groups (P<0.05) . At 3 months postoperatively, the incidence of urinary incontinence was significantly lower in the experimental group compared to the control group (P<0.05) . At 6 months postoperatively, both groups showed a significant increase in International Index of Erectile Function-5 (IIEF-5) scores compared to preoperative values (P<0.05) , with no significant difference between the two groups. The incidence of retrograde ejaculation in the experimental group was significantly lower than that in the control group (P<0.05) . CONCLUSIONS: Retaining part of the urethral mucosa in HoLEP surgery can effectively treat BPH, providing significant advantages in terms of urinary control and playing a positive role in overall postoperative sexual function recovery.