Transient urinary incontinence may occur in up to 44% of patients after holmium laser enucleation of the prostate (HoLEP). However, there are few published data concerning the factors associated with de novo urinary incontinence (UI). The aim of this study was to investigate whether morphological characteristics of prostate are associated with de novo UI after HoLEP.

Our study included 223 patients who underwent HoLEP. Morphological characteristics of prostate was estimated by a trans-rectal ultrasonography (TRUS) such as size, width, depth, longitudinal diameter, presence of intravesical prostatic protrusion, posterior depth, and anterior depth. Anterior depth of prostate was defined as a diameter from prostate urethra to anterior prostate capsule on a sagittal plane of TRUS. Enrolled patients were divided into two groups according to the presence of UI. Independent t test was used to compare between two groups. Logistic regression analysis was performed to investigate a correlation with de novo UI.

After HoLEP, 68 patients (30.4%) had de novo UI, most of them resolved within 1-6 months. Age and anterior depth of prostate were significantly higher in UI group than non-UI group (76.07 ± 5.82 vs 72.01 ± 8.04 years; P = 0.007, 18.61 ± 3.89 vs 11.84 ± 3.70 mm, P < 0.001). There were no significant differences in the other morphological characteristics, prostate volume, retrieved tissue weight, and operative time between two groups. In a logistic linear regression analysis, only anterior depth of prostate was an independent predictor of de novo UI after HoLEP.

About one-third of patients might undergo de novo UI following HoLEP, and most of them might have been resolved within 1-6 months. Thick anterior depth of prostate is associated with de novo UI after HoLEP

Anterior depth of prostate on TRUS could be used as a practical tool to predict postoperative de novo UI.