["3+1" bladder function restoration combined with holmium laser enucleation of the prostate for benign prostatic hyperplasia with acontractile detrusor].

Objective: To investigate the clinical effect of "3+1" bladder function restoration combined with holmium laser enucleation of the prostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH) with acontractile detrusor (ACD).

Methods: We treated 35 BPH patients with ACD by HoLEP followed by "3+1" bladder function restoration, that is, a 3-phase bladder function training plus simultaneous 1-drug medication after surgery. We recorded and analyzed the detrusor pressure, post-void residual urine volume (PVR), maximum urinary flow rate (Qmax), International Prognostic Scoring System (IPSS) scores, quality of life (QoL), voluntary micturition, satisfaction with the bladder function, hydronephrosis, ureterectasia, renal function, and urinary tract infection of the patients before and after treatment.

Results: Compared with the base line, at 6 months treatment, the patients showed significantly increased detrusor pressure (［35.1±2.7］vs ［50.2±2.3］ cmH2O, P<0.05) and Qmax (［4.2±2.7］vs ［21.1±4.1］ ml/s, P<0.05) but decreases in PVR (［173.0±31.6］ vs ［30.5±12.9］ml, IPSS score (27.3±3.2 vs 5.1±1.4, P<0.05) and QoL (4.1±0.8 vs 0.8±0.1, P<0.05), elevated rates of voluntary urination (0% ［0/35］ vs 100% ［35/35］, P<0.05), regularurination (0% ［0/35］ vs 85.71% ［30/35］, P<0.05), grade Ⅰ satisfaction with bladder function (0% ［0/35］ vs 85.71% ［30/35］, P<0.05), reduced rate of overflowing urinary incontinence (28.57% ［10/35］ vs 5.71% ［2/35］, P<0.05), and increased percentages of normal renal function (34.29% ［12/35］ vs 85.71% ［30/35］, P<0.05) and non-infection of the urinary system (17.14% ［6/35］ vs 94.29% ［33/35］, P<0.05). After treatment, urination was markedly improved in 94.29% (33/35) of the patients.

Conclusions: "3+1" bladder function restoration combined with HoLEP produced a desirable effect on BPH with ACD, though its long-term effect remains to be further investigated.