Bowel Dysfunction and HoLEP Outcomes

Northwestern University126 enrolled

Overview

The objective of this prospective study is to examine the correlation and effects of bowel dysfunction on outcomes for patients undergoing holmium laser enucleation of prostate (HoLEP) for lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH).The investigator hypothesizes that patients who have more bowel dysfunction based on higher severity scores on patient-reported validated questionnaires will experience more symptoms in the immediate post-operative period and may have slower recovery of urinary control. Assessment of pre, peri, and post-procedural bowel dysfunction via the Constipation Severity Score (CSS) and Vaizey Incontinence Questionnaire will aid the analysis.

Study Type

OBSERVATIONAL

Enrollment

126

Conditions

Urologic Injuries

Interventions

Bowel function post Holmium Laser Enucleation of the ProstatePROCEDURE

Observing post operative bowel functions among participants who have undergone a HoLEP procedure.

Medical Language ↔ Plain English

Inclusion Criteria: * Males18-89 undergoing HoLEP * Able to read, understand, and complete patient questionnaires * Willing to sign the informed consent form Exclusion Criteria: * Patients with bowel diversion (colostomy, ileostomy) * Patients with known neurogenic bowel * Patients having concurrent ureteroscopy+/-laser lithotripsy, percutaneous nephrolithotomy, or non-urologic surgery at time of HoLEP * Anticipated need for perineal urethrostomy at time of HoLEP * Prior pelvic radiation or patients with history of bladder cancer with or without Bacillus Calmette-Guerin (BCG) therapy * Patients who lack decisional capacity

Outcomes

Primary Outcomes

Difference in American Urologic Association Symptom Score (AUASS)

Identifying differences in AUASS scores pre-operatively versus post-operatively. An AUA symptom score of 0-7 is considered mild, 8-19 is moderate, and 20-35 is severe. This will be used in combination with the other measures to come up with total severity of overall condition.

Time frame: 3 months

Collecting preoperative bowel dysfunction scores via Constipation Severity Scale (CSS) and Vaizey Incontinence questionnaires

Identifying differences in CSS/Vaizey Incontinence questionnaires at pre-op 3- month clinic follow-up. Minimum score of 0 indicates perfect continence versus 24 which indicates total incontinence. This will be used in combination with the other measures to come up with total severity of overall condition.

Time frame: 3 months

Secondary Outcomes

Change between pre-operative and post-operative bowel dysfunction scores and symptoms

Identifying changes in symptom management/resolve: post-op retention, time with catheter, gross hematuria, Urinary Tract Infection, Emergency Department visits and any other complications. This will be used in combination with the other measures to come up with total severity of overall condition.

Time frame: 6 months

Monitoring efficacy of procedure

Identifying changes with post void residual, Michigan Incontinence Score Index (MISI). With a score range of 0-32, identifying severity and total bother. This will be used in combination with the other measures to come up with total severity of overall condition.

Time frame: 1 year