Urinary Incontinence: Outcomes & Complications

Moderated Poster Session

MP3-18 - Early outcomes with immediate postoperative pelvic floor therapy (PFPT) after Holmium Laser Enucleation of the Prostate (HoLEP).

Thursday, September 20
4:00 PM - 6:00 PM
Location: Room 243

Introduction & Objective : Long term urge and stress urinary incontinence (SUI) is rarely seen after HoLEP. However, short-term temporary incontinence is common.  At our institution, patients are provided with literature on pelvic floor exercises to expedite recovery of continence postoperatively. Despite this, we suspect that early instruction by a physical therapist, specializing in PFPT, improves early return of continence and overall patient satisfaction. Therefore, every patient is offered instruction by our pelvic floor therapist after their catheter has been removed on post-operative day one from their HoLEP procedure.


Methods : This is a retrospective review of 262 patients who underwent HoLEP between March 1st and September 1st 2017. 80 patients consented to participate in our prospectively maintained HoLEP database and responded to our 6-week postoperative questionnaire. Of these patients 30 underwent PFPT after the catheter was removed on postoperative day 1. This involved instruction from our PFPT specialist on techniques to contract the pelvic floor in isolation without use of abdominal, gluteal or hip muscles while in the hook-laying, sitting, standing or squatting position. Patients responded to questionnaire consisting of international continence society questionnaire (ICS), AUA symptom score, BPH index and michigan incontinence symptom index (MISI) 6 weeks after HoLEP. Patients were asked if they wore pads, the number of pads, and the number of weeks until they regained their continence.


Results : Baseline demographics between the PFPT and non-PFPT is shown in table 1. Though no statistical significance was seen, there was a trend, for PFPT versus non-PFPT, toward decreased number of people wearing pads (37% vs 48%), less time to continence (4.8 vs 5.1), and very satisfied (69% vs 50%).


Conclusions : Although improvements in the short-term post-HoLEP continence was demonstrated with PFPT, these findings were not statistically significant.   A larger scale prospective study is needed to discern if these differences are clinically significant in order to justify the cost of PFPT postoperatively.

Tim Large

Endourology Fellow
Indiana University School of Medicine

Name: Tim Large MD
Title: Endourology Fellow - Indiana University School of Medicine
Affiliation: IU-Methodist Hospital

I am currently in the second year of fellowship with Drs. Lingeman and Krambeck at Indiana University in Indianapolis, Indiana. We focus on the management of stones and symptomatic benign prostate hyperplasia.

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    Blake Anderson

    Endourology Fellow
    Indiana University School of Medicine

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      Joshua Heiman

      Medical Student
      Indiana University School of Medicine

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        James E. Lingeman

        Professor
        Indiana University School of Medicine

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          Amy E. Krambeck

          Professor
          Indiana University School of Medicine

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