Incidence and patterns of urinary incontinence following endoscopic prostate enucleation: A 7-year single-center experience

Meshcheriakova E.A., Nesterova O.Yu., Strigunov A.A., Khokhlov M.A., Burlakov I.D., Yusupov K.M., Nikolaev M.Yu., Lee S. Sorokin N.I. Kamalov A.A.

1) Lomonosov Moscow State University, University Clinic, Medical Scientific and Educational Institute, Moscow, Russian Federation; 2) Lomonosov Moscow State University, Faculty of Fundamental Medicine, Medical Scientific and Educational Institute, Moscow, Russian Federation

Introduction. Endoscopic enucleation of benign prostatic hyperplasia (BPH) is currently considered a treatment of choice for patients with BPH of any volume, including those in whom discontinuation of anticoagulant or antiplatelet therapy is not feasible. However, urinary incontinence remains one of the most common postoperative complications, significantly affecting patient’s quality of life.
Objective: to evaluate the incidence and patterns of urinary incontinence following endoscopic enucleation, as well as to compare preoperative and intraoperative characteristics among patients with different types of incontinence.
Materials and Methods. This single-center observational cohort study included patients with BPH who underwent endoscopic enucleation between March 2019 and December 2025. Data were collected prospectively and analyzed retrospectively. Urinary incontinence was defined as any involuntary leakage of urine. Statistical analysis was performed using the R programming language (RStudio version 2025.05.1+513).
Results. Among 1,094 patients, urinary incontinence (of any type) was observed in 13.7% of cases (150/1094). Of these, 48 patients (32.0%) had urge incontinence, 75 (50.0%) had stress incontinence, and 27 (18.0%) had mixed incontinence. In the majority of cases, incontinence was transient: 61 patients (40.7% of incontinent patients and 5.6% of the total cohort) experienced symptoms lasting up to 1 month, 80 patients (53.3% and 7.3%, respectively) between 1 and 3 months, and 9 patients (6.0% and 0.8%, respectively) for more than 3 months. Persistent incontinence beyond 12 months was observed in only one patient (0.091%) with myasthenia gravis. The time to continence recovery did not differ significantly between incontinence types (p = 0.95). Comparative analysis of preoperative, intraoperative, and postoperative parameters demonstrated that patients with stress urinary incontinence had a higher body mass index, less pronounced storage symptoms according to IPSS, less frequent use of antimuscarinics and beta-3-agonists prior to surgery, and a lower rate of early apical sphincter release during enucleation. Patients with mixed incontinence more commonly had cerebrovascular disease.
Conclusion. Urinary incontinence following endoscopic prostate enucleation occurs in 13.7% of patients and is transient in the majority of cases, resolving within the first three postoperative months. The rate of continence recovery is comparable across different types of incontinence, indicating a favorable functional prognosis in this patient population.

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About the Authors

Corresponding author: Olga Yu. Nesterova – M.D., Cand. Sc. (Med), Urologist, Senior Researcher, Urology and Andrology Unit, University Clinic, Medical Scientific and Educational Institute, Lomonosov Moscow State University, senior lecturer of the Dept. of Urology and Andrology, Faculty of Fundamental Medicine, Medical Scientific and Educational Institute, Lomonosov Moscow State University. Moscow, Russian Federation; e-mail: oy.nesterova@gmail.com

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