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Objectives <p>To compare functional outcomes and complications of HoLEP using 22–26&#xa0;F sheath.</p> Patients and Methods <p>This retrospective analysis included data from patients who underwent HoLEP between May 2023 and September 2024. Patients were divided into two groups: Group 1 (22&#xa0;F sheath) and Group 2 (26&#xa0;F sheath). Functional outcomes assessed included International Prostate Symptom Score (IPSS), maximum flow rates (Q-max), and postvoid residual (PVR). Assessed complications were incidence of stress and urge incontinence, and urethral stricture. Follow-up was done at 1, 3, 6, and 12 months.</p> Results <p>A total of 190 patients were included (94 in Group 1 and 96 in Group 2). Intraoperative complications (two patients in group 2) and re-admission rates (one patient for each group for clot retention) were comparable. No major complications were reported. Group 1 demonstrated significantly lower IPSS scores at all follow-up intervals. Starting from third month follow-up, Q-max was significantly better for group 2. PVR was significantly better in group 2 in all follow-up intervals. Transient stress urinary incontinence rates were lower in group 1 at one and three months (<i>P</i> &lt; 0.001 and 0.045 respectively). Then both groups had comparable results. Urge urinary incontinence rates were lower in group 1 at one month (<i>P</i> = 0.001), then they became comparable. Urethral stricture rates were 3.2% for 22&#xa0;F group versus 6.2% for 26&#xa0;F group, <i>P</i> = 0.321. In multivariate analysis, Sheath size was the only independent predictor of overall complications where odds ratio for 26&#xa0;F sheath was 3.123, 95%CI: 1.15–8.48, <i>P</i> = 0.025).</p> Conclusions <p>The use of 22&#xa0;F sheath in HoLEP showed improving IPSS and better early continence. The use of 26&#xa0;F sheath resulted in better urine flow but was associated with more overall complications.</p>

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Impact of sheath size on HoLEP outcomes: a comparative study between 22 F and 26 F sheaths

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月22日

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  • Abdulaziz Alshammari,
  • Faisal H. Alhajeri,
  • Mariam Boualbanat,
  • Saad Alghadouri,
  • Basel Alansari,
  • Abdalla Alamran,
  • Saad Alenezi,
  • Abdullah Alrefai,
  • Sameh Mohammed,
  • Ali Alamiri,
  • Omar Alhunaidi,
  • Ahmed R. EL-Nahas,
  • Abdulrahman Alkandari

摘要

Objectives

To compare functional outcomes and complications of HoLEP using 22–26 F sheath.

Patients and Methods

This retrospective analysis included data from patients who underwent HoLEP between May 2023 and September 2024. Patients were divided into two groups: Group 1 (22 F sheath) and Group 2 (26 F sheath). Functional outcomes assessed included International Prostate Symptom Score (IPSS), maximum flow rates (Q-max), and postvoid residual (PVR). Assessed complications were incidence of stress and urge incontinence, and urethral stricture. Follow-up was done at 1, 3, 6, and 12 months.

Results

A total of 190 patients were included (94 in Group 1 and 96 in Group 2). Intraoperative complications (two patients in group 2) and re-admission rates (one patient for each group for clot retention) were comparable. No major complications were reported. Group 1 demonstrated significantly lower IPSS scores at all follow-up intervals. Starting from third month follow-up, Q-max was significantly better for group 2. PVR was significantly better in group 2 in all follow-up intervals. Transient stress urinary incontinence rates were lower in group 1 at one and three months (P < 0.001 and 0.045 respectively). Then both groups had comparable results. Urge urinary incontinence rates were lower in group 1 at one month (P = 0.001), then they became comparable. Urethral stricture rates were 3.2% for 22 F group versus 6.2% for 26 F group, P = 0.321. In multivariate analysis, Sheath size was the only independent predictor of overall complications where odds ratio for 26 F sheath was 3.123, 95%CI: 1.15–8.48, P = 0.025).

Conclusions

The use of 22 F sheath in HoLEP showed improving IPSS and better early continence. The use of 26 F sheath resulted in better urine flow but was associated with more overall complications.