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Change of nocturnal polyuria after holmium laser enucleation of the prostate in patients with benign prostatic hyperplasia.
Urology. 2014 Sep; 84(3):650-6.U

Abstract

OBJECTIVE

To evaluate changes of nocturnal polyuria (NP) after holmium laser enucleation of the prostate (HoLEP) in patients with nocturia preoperatively.

PATIENTS AND METHODS

This retrospective study included patients who underwent HoLEP for benign prostatic hyperplasia and recorded 3-day frequency-volume chart strictly. Patients who had a history of prostate cancer, sleep apnea, renal failure, heart failure, or medication of desmopressin were excluded. Nocturia is defined as ≥ 1 void at night, and NP is defined by nocturnal polyuria index (NPI) >33%. Among 472 patients included in the final analysis, 352 men (74.6%) presented nocturia preoperatively. Among those, 205 men (58.2%) who had NP preoperatively were allocated to group NP, and 147 men who did not were allocated to group non-NP.

RESULTS

In total patients, nocturnal frequency was decreased significantly starting from 3 months after the HoLEP. In NP group, mean value of NPI decreased by 4.1% ± 10.7%, 6.0% ± 9.4%, 6.2% ± 9.5%, and 4.8% ± 11.4% at postoperative months 1, 3, 6, and 12, respectively. The proportion of patients who showed decreased NPI to the normal range (≤ 33%) were 32.5%, 36.1%, 37.7%, and 31.0% at postoperative months 1, 3, 6, and 12, respectively. On receiver operating characteristics curve analysis, an absolute reduction of NPI of ≥ 6.0% was shown as a significant predictor for improved nocturia (≥ 50% reduction of nocturnal frequency).

CONCLUSION

In our study, the improvement of NP after HoLEP was observed. This suggests that relieving lower urinary tract obstruction has a positive influence on NP, and it could be a new strategy for treatment of NP.

Authors+Show Affiliations

Department of Urology, Konkuk University Medical Center, Seoul, Korea.Department of Urology, Seoul National University Hospital, Seoul, Korea.Department of Urology, Seoul National University Hospital, Seoul, Korea.Department of Urology, Seoul National University Hospital, Seoul, Korea.Department of Urology, Seoul National University Hospital, Seoul, Korea. Electronic address: jspaick@snu.ac.kr.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25168546

Citation

Choi, Woo Suk, et al. "Change of Nocturnal Polyuria After Holmium Laser Enucleation of the Prostate in Patients With Benign Prostatic Hyperplasia." Urology, vol. 84, no. 3, 2014, pp. 650-6.
Choi WS, Ku JH, Oh SJ, et al. Change of nocturnal polyuria after holmium laser enucleation of the prostate in patients with benign prostatic hyperplasia. Urology. 2014;84(3):650-6.
Choi, W. S., Ku, J. H., Oh, S. J., Kim, S. W., & Paick, J. S. (2014). Change of nocturnal polyuria after holmium laser enucleation of the prostate in patients with benign prostatic hyperplasia. Urology, 84(3), 650-6. https://doi.org/10.1016/j.urology.2014.05.040
Choi WS, et al. Change of Nocturnal Polyuria After Holmium Laser Enucleation of the Prostate in Patients With Benign Prostatic Hyperplasia. Urology. 2014;84(3):650-6. PubMed PMID: 25168546.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Change of nocturnal polyuria after holmium laser enucleation of the prostate in patients with benign prostatic hyperplasia. AU - Choi,Woo Suk, AU - Ku,Ja Hyeon, AU - Oh,Seung-June, AU - Kim,Soo Woong, AU - Paick,Jae-Seung, PY - 2014/02/23/received PY - 2014/05/24/revised PY - 2014/05/29/accepted PY - 2014/8/30/entrez PY - 2014/8/30/pubmed PY - 2014/10/29/medline SP - 650 EP - 6 JF - Urology JO - Urology VL - 84 IS - 3 N2 - OBJECTIVE: To evaluate changes of nocturnal polyuria (NP) after holmium laser enucleation of the prostate (HoLEP) in patients with nocturia preoperatively. PATIENTS AND METHODS: This retrospective study included patients who underwent HoLEP for benign prostatic hyperplasia and recorded 3-day frequency-volume chart strictly. Patients who had a history of prostate cancer, sleep apnea, renal failure, heart failure, or medication of desmopressin were excluded. Nocturia is defined as ≥ 1 void at night, and NP is defined by nocturnal polyuria index (NPI) >33%. Among 472 patients included in the final analysis, 352 men (74.6%) presented nocturia preoperatively. Among those, 205 men (58.2%) who had NP preoperatively were allocated to group NP, and 147 men who did not were allocated to group non-NP. RESULTS: In total patients, nocturnal frequency was decreased significantly starting from 3 months after the HoLEP. In NP group, mean value of NPI decreased by 4.1% ± 10.7%, 6.0% ± 9.4%, 6.2% ± 9.5%, and 4.8% ± 11.4% at postoperative months 1, 3, 6, and 12, respectively. The proportion of patients who showed decreased NPI to the normal range (≤ 33%) were 32.5%, 36.1%, 37.7%, and 31.0% at postoperative months 1, 3, 6, and 12, respectively. On receiver operating characteristics curve analysis, an absolute reduction of NPI of ≥ 6.0% was shown as a significant predictor for improved nocturia (≥ 50% reduction of nocturnal frequency). CONCLUSION: In our study, the improvement of NP after HoLEP was observed. This suggests that relieving lower urinary tract obstruction has a positive influence on NP, and it could be a new strategy for treatment of NP. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/25168546/Change_of_nocturnal_polyuria_after_holmium_laser_enucleation_of_the_prostate_in_patients_with_benign_prostatic_hyperplasia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-4295(14)00579-2 DB - PRIME DP - Unbound Medicine ER -