Etiology and treatment of dysuria shortly after holmium laser enucleation of the prostate: a report of 98 cases
10.12483/j.issn.1009-8291.2026.05.006
- VernacularTitle:经尿道前列腺钬激光剜除术后近期发生排尿困难的原因及治疗（附98例报告）
- Author:
Chao LU
1
;
Xin GU
1
;
Wenfeng LI
1
;
Chong LIU
1
;
Bao HUA
1
;
Jiangyi WANG
1
;
Minkai XIE
1
;
Yiwei WANG
1
;
Qing YANG
1
Author Information
1. Department of Urology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 201999, China
- Publication Type:Journal Article
- Keywords:
benign prostatic hyperplasia;
transurethral holmium laser prostate enucleation;
dysuria;
urethral stricture
- From:
Journal of Modern Urology
2026;31(5):435-439
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the etiology and treatment of dysuria shortly after holmium laser enucleation of the prostate (HoLEP) for benign prostatic hyperplasia (BPH), so as to improve the therapeutic efficacy. Methods A retrospective analysis was conducted on 1361 BPH patients who received HoLEP at our hospital during Mar. 2018 and Mar. 2025. All patients underwent ultrasound, computed tomography (CT), urethral probing or radiography, cystourethroscopy, and urodynamic testing. The causes, treatments and prognosis of dysuria after operation were summarized. Results ninety-eight patients (7.2%) experienced dysuria within 3 months after surgery, and all patients received initial urethral dilation. Among the 62 cases with urethral stricture, 28 were treated with urethral dilation (average of 8 sessions), 16 underwent external urethral incision, 8 underwent anterior urethroplasty, and 10 underwent transurethral plasma incision for urethral stricture. Of the 12 cases with residual prostate tissue, 5 underwent urethral plasma prostatectomy and 7 received medication. All of the 12 cases with bladder neck contracture underwent transurethral plasma incision of the bladder neck and local drug injection. Five cases with intravesical blood clots underwent urethral blood clot irrigation, 2 of which developed active bleeding and then underwent electrocoagulation. Four cases with detrusor dysfunction had catheters re-indwelled for one week followed by medication. Two cases with stone and one case with tissue fragment impacted in the urethra underwent urethral holmium lithotripsy and cystoscopic removal. All patients underwent reoperation successfully and experienced complete resolution or significant improvement of urinary difficulties. Conclusion A certain proportion of patients experience dysuria after HoLEP, with diverse etiologies. The combination of prevention and treatment can reduce the incidence of dysuria.
