Predictive factors for the development of urethral stricture in patients undergoing holmium laser enucleation of the prostate: A retrospective study

This study aimed to determine the incidence and predictors of urethral stricture after holmium laser enucleation of the prostate (HoLEP) and to assess the safety of the procedure. We retrospectively reviewed data from 202 patients who underwent HoLEP. Patients were divided into 2 groups: those with urethral stricture (group 2) and those without (group 1). Preoperative prostate-specific antigen (PSA), uroflowmetry with post-void residual (PVR), and International Prostate Symptom Score (IPSS) were evaluated. Multivariate logistic regression analysis was performed to identify independent predictors of urethral stricture. Perioperative complications were classified according to the Clavien-Dindo system. The mean age was 67.0 ± 7.6 years in group 1 and 68.4 ± 7.3 years in group 2 (P = .335). Urethral stricture developed in 6.4% of patients. Multivariate analysis revealed that preoperative prostatitis (odds ratio [OR]: 116.81; 95% confidence interval [CI]: 1.32-10,330; P = .047) and the use of general anesthesia (OR: 269.07; 95% CI: 7.30-9912.74; P = .047) were independent predictors of stricture formation. Preoperative prostatitis and general anesthesia significantly increase the risk of urethral stricture after HoLEP.