Top

World Journal of Urology

Published in:

Open Access 01-09-2021 | Stress Incontinence | Original Article

Development and validation of a nomogram for predicting early stress urinary incontinence following endoscopic enucleation of the prostate

Authors: Xuanhao Li, Fei He, Cong Huang, Liangshuo Zhang, Qiang Liu, Jian Song

Published in: World Journal of Urology | Issue 9/2021

Abstract

Purpose

To develop and validate a predictive nomogram for early stress urinary incontinence (SUI) after endoscopic enucleation of the prostate (EEP) in patients with benign prostatic hyperplasia (BPH).

Methods

The records of 458 patients who underwent plasmakinetic- or diode-based EEP at our center from March 2016 to December 2019 were reviewed. Among these, 326 and 132 cases were randomly assigned to the training and validation set, respectively. A predictive nomogram was constructed based on multivariate logistic regression analysis. Receiver operating characteristic (ROC) analysis and calibration curves were employed to evaluate its performance.

Results

65 years ≤ age < 70 years, 75 years ≤ age, 25 kg/m² ≤ BMI < 30 kg/m², 30 kg/m² ≤ BMI, 5 years ≤ LUTS duration, and 75 ml ≤ prostate volume were finally selected as independent predictors of early SUI into the multivariate logistics regression model. It was visualized as a concise nomogram with satisfactory discrimination and accuracy in both training and validation sets.

Conclusions

A concise nomogram was developed and validated as a useful clinical tool for predicting early SUI post-EEP.

Available only for authorised users

Scoffone CM, Cracco CM (2019) Holmium laser enucleation of the prostate. Curr Opin Urol 29(3):304–305. https://doi.org/10.1097/MOU.0000000000000609CrossRefPubMed

Huang SW, Tsai CY, Tseng CS, Shih MC, Yeh YC, Chien KL, Pu YS, Tu YK (2019) Comparative efficacy and safety of new surgical treatments for benign prostatic hyperplasia: systematic review and network meta-analysis. BMJ 367:l5919. https://doi.org/10.1136/bmj.l5919CrossRefPubMedPubMedCentral

Lerner LB, Tyson MD, Mendoza PJ (2010) Stress incontinence during the learning curve of holmium laser enucleation of the prostate. J Endourol 24(10):1655–1658. https://doi.org/10.1089/end.2010.0021CrossRefPubMed

Nam JK, Kim HW, Lee DH, Han JY, Lee JZ, Park SW (2015) Risk factors for transient urinary incontinence after holmium laser enucleation of the prostate. World J Mens Health 33(2):88–94. https://doi.org/10.5534/wjmh.2015.33.2.88CrossRefPubMedPubMedCentral

Vavassori I, Hurle R, Vismara A, Manzetti A, Valenti S (2004) Holmium laser enucleation of the prostate combined with mechanical morcellation: two years of experience with 196 patients. J Endourol 18(1):109–112. https://doi.org/10.1089/089277904322836767CrossRefPubMed

He G, Shu Y, Wang B, Du C, Chen J, Wen J (2019) Comparison of diode laser (980 nm) enucleation vs holmium laser enucleation of the prostate for the treatment of benign prostatic hyperplasia: a randomized controlled trial with 12-month follow-up. J Endourol 33(10):843–849. https://doi.org/10.1089/end.2019.0341CrossRefPubMed

Hirasawa Y, Kato Y, Fujita K (2018) Age and prostate volume are risk factors for transient urinary incontinence after transurethral enucleation with bipolar for benign prostatic hyperplasia. Int J Urol 25(1):76–80. https://doi.org/10.1111/iju.13472CrossRefPubMed

Walz J, Burnett AL, Costello AJ, Eastham JA, Graefen M, Guillonneau B, Menon M, Montorsi F, Myers RP, Rocco B, Villers A (2010) A critical analysis of the current knowledge of surgical anatomy related to optimization of cancer control and preservation of continence and erection in candidates for radical prostatectomy. Eur Urol 57(2):179–192. https://doi.org/10.1016/j.eururo.2009.11.009CrossRefPubMed

Endo F, Shiga Y, Minagawa S, Iwabuchi T, Fujisaki A, Yashi M, Hattori K, Muraishi O (2010) Anteroposterior dissection HoLEP: a modification to prevent transient stress urinary incontinence. Urology 76(6):1451–1455. https://doi.org/10.1016/j.urology.2010.03.071CrossRefPubMed

10.

Buckley BS, Lapitan MC, Glazener CM, Group MT (2012) The effect of urinary incontinence on health utility and health-related quality of life in men following prostate surgery. Neurourol Urodyn 31(4):465–469. https://doi.org/10.1002/nau.21231CrossRefPubMed

11.

Barnoiu OS, Garcia EG, Baron FL, Vozmediano RC, Soler JM, Del Rosal Samaniego JM, Machuca JS, Baena VG (2014) Prospective urodynamic model for prediction of urinary incontinence after robot-assisted radical prostatectomy. Urol Int 92(3):306–309. https://doi.org/10.1159/000354352CrossRefPubMed

12.

Jeong SJ, Yeon JS, Lee JK, Cha WH, Jeong JW, Lee BK, Lee SC, Jeong CW, Kim JH, Hong SK, Byun SS, Lee SE (2014) Development and validation of nomograms to predict the recovery of urinary continence after radical prostatectomy: comparisons between immediate, early, and late continence. World J Urol 32(2):437–444. https://doi.org/10.1007/s00345-013-1127-yCrossRefPubMed

13.

Du C, Jin X, Bai F, Qiu Y (2008) Holmium laser enucleation of the prostate: the safety, efficacy, and learning experience in China. J Endourol 22(5):1031–1036. https://doi.org/10.1089/end.2007.0262CrossRefPubMed

14.

Bae J, Kang HW, Lee HW, Lee KS, Cho MC (2016) Predictors of de novo urge urinary incontinence after photoselective vaporization of the prostate. World J Urol 34(3):413–418. https://doi.org/10.1007/s00345-015-1635-zCrossRefPubMed

15.

Houssin V, Olivier J, Brenier M, Pierache A, Laniado M, Mouton M, Theveniaud PE, Baumert H, Mallet R, Marquette T, Villers A, Robert G, Rizk J (2020) Predictive factors of urinary incontinence after holmium laser enucleation of the prostate: a multicentric evaluation. World J Urol. https://doi.org/10.1007/s00345-020-03169-0CrossRefPubMed

16.

Martin SA, Haren MT, Marshall VR, Lange K, Wittert GA, Florey Adelaide Male Ageing S (2011) Prevalence and factors associated with uncomplicated storage and voiding lower urinary tract symptoms in community-dwelling Australian men. World J Urol 29(2):179–184. https://doi.org/10.1007/s00345-010-0605-8CrossRefPubMed

17.

Elmansy HM, Kotb A, Elhilali MM (2011) Is there a way to predict stress urinary incontinence after holmium laser enucleation of the prostate? J Urol 186(5):1977–1981. https://doi.org/10.1016/j.juro.2011.06.063CrossRefPubMed

18.

Xu N, Chen SH, Xue XY, Wei Y, Zheng QS, Li XD, Huang JB, Cai H, Sun XL, Lin YZ (2017) Older age and larger prostate volume are associated with stress urinary incontinence after plasmakinetic enucleation of the prostate. Biomed Res Int 2017:6923290. https://doi.org/10.1155/2017/6923290CrossRefPubMedPubMedCentral

19.

Chapple CR, Wein AJ, Abrams P, Dmochowski RR, Giuliano F, Kaplan SA, McVary KT, Roehrborn CG (2008) Lower urinary tract symptoms revisited: a broader clinical perspective. Eur Urol 54(3):563–569. https://doi.org/10.1016/j.eururo.2008.03.109CrossRefPubMed

20.

Temml C, Brossner C, Schatzl G, Ponholzer A, Knoepp L, Madersbacher S (2003) The natural history of lower urinary tract symptoms over five years. Eur Urol 43(4):374–380. https://doi.org/10.1016/s0302-2838(03)00084-8CrossRefPubMed

21.

Kwon T, Park S, Park S, Moon KH (2017) Metabolic syndrome is predictive of lower urinary tract symptom improvement after holmium laser enucleation of the prostate for benign prostatic obstruction. Int Urol Nephrol 49(7):1105–1110. https://doi.org/10.1007/s11255-017-1580-4CrossRefPubMed

22.

Fu Y, Zhou Z, Yang B, Zhang K, He L, Zhang X (2016) The relationship between the clinical progression of benign prostatic hyperplasia and metabolic syndrome: a prospective study. Urol Int 97(3):330–335. https://doi.org/10.1159/000448484CrossRefPubMed

23.

Kobayashi S, Yano M, Nakayama T, Kitahara S (2016) Predictive risk factors of postoperative urinary incontinence following holmium laser enucleation of the prostate during the initial learning period. Int Braz J Urol 42(4):740–746. https://doi.org/10.1590/S1677-5538.IBJU.2015.0477CrossRefPubMedPubMedCentral

24.

Fujisaki A, Goto A, Endo F, Muraishi O, Hattori K, Yasumura S (2016) Practical index of urinary incontinence following holmium laser enucleation of the prostate: a case-series study of the 24-hour pad test immediately after catheter removal. Urol Int 97(3):310–319. https://doi.org/10.1159/000449016CrossRefPubMed

25.

Bleeker SE, Moll HA, Steyerberg EW, Donders AR, Derksen-Lubsen G, Grobbee DE, Moons KG (2003) External validation is necessary in prediction research: a clinical example. J Clin Epidemiol 56(9):826–832. https://doi.org/10.1016/s0895-4356(03)00207-5CrossRefPubMed

26.

Moons KG, Altman DG, Reitsma JB, Collins GS (2015) New guideline for the reporting of studies developing, validating, or updating a multivariable clinical prediction model: the TRIPOD statement. Adv Anat Pathol 22(5):303–305. https://doi.org/10.1097/pap.0000000000000072CrossRefPubMed

27.

Chang PL, Tsai LH, Huang ST, Wang TM, Hsieh ML, Tsui KH (1998) The early effect of pelvic floor muscle exercise after transurethral prostatectomy. J Urol 160(2):402–405CrossRef

28.

Chang JI, Lam V, Patel MI (2016) Preoperative pelvic floor muscle exercise and postprostatectomy incontinence: a systematic review and meta-analysis. Eur Urol 69(3):460–467. https://doi.org/10.1016/j.eururo.2015.11.004CrossRefPubMed

29.

Anan G, Kaiho Y, Iwamura H, Ito J, Kohada Y, Mikami J, Sato M (2020) Preoperative pelvic floor muscle exercise for early continence after holmium laser enucleation of the prostate: a randomized controlled study. BMC Urol 20(1):3. https://doi.org/10.1186/s12894-019-0570-5CrossRefPubMedPubMedCentral

30.

Xiao KW, Zhou L, He Q, Chen G, Gao XS, Liu Y, Li H, Wang KJ (2020) Transurethral endoscopic enucleation of the prostate using a diode laser versus bipolar plasmakinetic for benign prostatic obstruction: a meta-analysis. Lasers Med Sci. https://doi.org/10.1007/s10103-020-02949-9CrossRefPubMed

Title: Development and validation of a nomogram for predicting early stress urinary incontinence following endoscopic enucleation of the prostate
Authors: Xuanhao Li
Fei He
Cong Huang
Liangshuo Zhang
Qiang Liu
Jian Song
Publication date: 01-09-2021
Publisher: Springer Berlin Heidelberg
Keyword: Stress Incontinence
Published in: World Journal of Urology / Issue 9/2021
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-021-03592-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Development and validation of a nomogram for predicting early stress urinary incontinence following endoscopic enucleation of the prostate

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 9/2021

Ejaculation-sparing versus non-ejaculation-sparing anatomic GreenLight laser enucleo-vaporization of the prostate: first comparative study

Can local treatment prolong the sensitivity of metastatic prostate cancer to androgen deprivation or even prevent castration resistance?

Every ureteral stone deserves conventional management prior to intervention

Integration of aquablation through telemetry: an alternative to onsite proctoring?

The negative aftermath of prostate biopsy: prophylaxis, complications and antimicrobial stewardship: results of the global prevalence study of infections in urology 2010–2019

Evaluation of a free 3D software for kidney stones’ surgical planning: “kidney stone calculator” a pilot study