TOPLINE

Among patients who underwent thulium fiber laser enucleation of the prostate (ThuFLEP), around 20% developed transient urinary incontinence 3 months after the procedure; however, rates decreased significantly by 12 months.

METHODOLOGY

• Researchers conducted a retrospective analysis of data from a single center to evaluate the incidence of urinary incontinence after ThuFLEP and identify factors associated with transient incontinence.
• They included 213 patients (mean age, 71.9 years; mean preoperative serum prostate-specific antigen level, 7.4 ng/mL) who underwent ThuFLEP between 2023 and 2024.
• Surgeons performed ThuFLEP using a thulium fiber laser; the mean operative time was 96.1 minutes, and the mean total energy delivered was 94.6 kJ.
• The main outcome was all-cause urinary incontinence, defined as patient-reported urine leakage that required the use of pads.
• Secondary outcomes were transient stress incontinence, urge incontinence, and persistent incontinence. Any urinary incontinence that was present at 3 months but resolved by 12 months was considered transient. 

TAKEAWAY

• At 3 months, 20.7% of patients had urinary incontinence, including stress incontinence (9.9%), urge incontinence (8%), and mixed incontinence (2.8%).
• By 12 months, the overall rate of incontinence fell to 6.6%, with stress incontinence and urge incontinence each reported in 2.3% of patients and mixed incontinence in 1.9% (P < .01 for all).
• In multivariable analysis, total laser energy delivered during the procedure was associated with higher odds of urinary incontinence at 3 months (odds ratio per kJ, 1.015; P = .025).
• Prostate volume, the technique for enucleation, and the experience of the surgeon showed no association with incontinence.

IN PRACTICE

“These findings carry important practical implications. Surgeons should try to limit the total laser energy delivered while still ensuring complete adenoma removal and secure hemostasis. In this context, energy per gram of resected tissue may serve as a more meaningful quality metric than total energy alone,” the researchers wrote.

SOURCE

This study was led by Valentin Caillault of the Department of Urology at Sorbonne University and Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital in Paris, France. It was published online on July 31, 2026, in the World Journal of Urology.

LIMITATIONS

No validated tools were used to assess urinary incontinence.

DISCLOSURES

The study reported no specific funding, and the authors declared no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.