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Resume Objectif Evaluer, en debut d’experience, la morbidite precoce et plus particulierement l’incontinence urinaire apres enucleation endoscopique de prostate au laser Holmium (HoLEP), en preciser la nature, l’evolution et rechercher des facteurs predictifs de survenue. Patients et methode Nous avons realise une etude observationnelle, analytique, retrospective, monocentrique incluant tous les patients operes d’une hypertrophie benigne de prostate (HBP) par HoLEP entre novembre 2015 et janvier 2017. Les donnees ont ete recueillies en pre-, per- et postoperatoire. Le suivi etait de 6 mois. Resultats Cent soixante et onze patients ont ete inclus. 23 patients (14,6 %) ont eu une complication classee selon Clavien-Dindo [4] : 19 (83 %) Clavien 2, 1 (4 %) Clavien 3b et 3 (13 %) Clavien 4. A 1 mois postoperatoire, 64 (42,7 %) patients presentaient une incontinence urinaire dont 55 (86,1 %) uniquement a l’effort. 18 (32,7 %) etaient incontinent urinaire a 6 mois. L’energie delivree en peroperatoire ainsi que l’IIEF5 preoperatoire etaient statiquement associes a la survenue d’une incontinence urinaire d’effort. Il n’a pas ete mis en evidence de lien entre l’apprentissage et la survenue de l’incontinence. Conclusion Le taux important d’incontinence urinaire post HoLEP en debut d’experience implique une reflexion sur la technique utilisee ainsi que sur l’information delivree aux patients en preoperatoire. Niveau de preuve 4.

Assess the early morbidity after HOLEP, the urinary incontinence in particular, and specify its different types, evolution, and predictive factors.We conducted an observational, analytical, retrospective, monocentric study including all patients undergoing surgery for benign prostatic hypertrophy (HBP) by HoLEP between November 2015 and January 2017. The data were collected pre-, per- and postoperatively. The follow-up was for 6 months.One hundred and seventy one patients were included. 23 patients (14.6%) had a complication according to Clavien-Dindo classification [4]: 19 (83%) Clavien 2, 1 (4%) Clavien 3b et 3 (13%) Clavien 4. At one month of the surgery, 64 (42.7%) patients had urinary incontinence of which 55 (86.1%) presented pure stress urinary incontinence. 18 (32.7%) were still incontinent at 6 months of the surgery. The delivered amount of energy during the surgery and the preoperative IIEF5 score were statistically significantly associated with the occurrence rate of stress urinary incontinence. There was no correlation between the surgeon's learning curve and the occurrence of incontinence.The occurrence rate of urinary incontinence post HoLEP might be related to the adopted surgical technique ; It is crucial to keep the patient well informed of the risk of this complication postoperatively.4.