Presented by: Amir Zarror MD
Department of Urology, Shamir Medical Center, Israel

Introduction

History of Parkinson’s Disease (PD) is considered a significant risk factor in patients undergoing BPH surgery, mainly due to increased risks of worse peri-operative outcome and post-operative incontinence. We sought to assess the short-term outcomes of these patients and compared it to patients without history of neurological disease.

Materials

We retrospectively reviewed all HoLEP surgeries performed by a single surgeon (EG) in two major hospitals from January 2020 to December 2022. We identified 7 patients with PD and compared it to 688 without known neurological disease, history of CVA or significant diabetic neuropathy.

Results

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Patients’ age was similar between the groups (68.8 in PD vs. 70.71 in control group, p=0.9). Compared to our control, patients with PD had smaller prostates (average prostate volume 82 vs. 122ml, p<0.028), and were more likely to have indwelling catheter prior to surgery (57% vs. 28%, p<0.01). One PD patient had mild urinary incontinence prior to surgery. There were no intraoperative complications in PD group. Postoperatively, one PD patient (14%) failed his initial voiding trial (compared to 8.3% in the control group) but five days later was able to void successfully. At time of last follow-up (2.7 months (PD group) vs 5.8 months) all PD patients were able to void spontaneously. One PD patient had new onset minimal urinary incontinence (protective pad) and one that was leaking prior to surgery has worsening of his symptoms. Although numbers are small, PD patients had significant improvement of IPSS and bother index (BI) in pre- vs. post-op period (IPSS - 25 pre vs. 11.75 post-op, BI – 5.2 vs.1.5).

Conclusion

When indicated, patients with PD should not be excluded from having BPH surgery. In our study, although small, all patients with PD who had HoLEP surgery were able to void spontaneously with minimal peri-operative complications and good functional outcome.

Funding

none

Lead Authors

Ehud Gnessin, MD
Shamir Medical Center and Assuta Hospital

Co-Authors

Itay Sabler, MD
Shamir Medical Center

Amnon Zisman, MD
Shamir Medical Center