攝護腺肥大的患者在藥物療效不彰後，往往需要手術治療；內視鏡攝護腺剜除手術，可以將攝護腺的增生腺體完整剜除，故儼然已成為目前較大攝護腺的黃金手術標準。然而，在術後有些患者會產生短暫向的尿失禁，雖然大多會在短時間內自然痊癒，但仍然是最惱人的病發症之一。因此，如何在術前先給病人正確的衛教是很重要的課題。

此篇文章統計了近四年間約四百位接受鈥雷射攝護腺剜除患者的病歷。目的是為了找出有哪些因子會造成患者更容易產生術後短暫尿失禁的問題，以及哪些因子可以預測患者的尿失禁能夠更早恢復。這篇文章比較特別的地方在於：把所有尿失禁（包括應力性尿失禁、急迫性尿失禁以及排尿後滴尿）都列入分析的範疇，相較於其他文章大多只有統計應力性尿失禁，來得更為全面一些。

在這些患者之中，總共有16.5%的患者（共65位）產生了術後的尿失禁，好在大部分（80%）的患者在三個月內都會恢復正常。在這65位患者中，16位是應力性尿失禁，29位是急迫性尿失禁，33位是解尿後有滴尿的狀況。在搜集了許多的臨床資料後，用回歸校正以及生存模式分析其相關性，其中發現年紀以及手術時間對於術後尿失禁有正相關性。

綜合以上結果討論，年紀越大的患者，在術後越容易引起此狀況。這並不令人意外；因為年紀較大的患者在骨盆底肌肉以及括約肌的肌力都較為弱，因此在手術後更容易產生短暫性的尿失禁，而在產生此狀況後，恢復的狀況相較於年輕患者也會有較長的恢復期。

另外手術時間對於術後短暫尿失禁的產生也有一定的影響力。由於此項術式雖然是自然開孔的內視鏡手術，身上並不會有多出傷口；然而，括約肌卻會被手術使用的內視鏡撐開、牽扯。所以手術時間越長，代表括約肌受到的外力越多，自然在術後產生此併發症的機會也會增加。

因此，年紀較大的患者，或是預期手術時間會較長的患者（通常手術時間與攝護腺體積大小及手術醫師經驗會有相關）在術前最好先與患者衛教術後可能出現的短暫尿失禁併發症，並在手術後仔細詢問術後恢復狀況並在病發正出現時給予適當治療，使患者能及早恢復正常生活。

Purpose: To investigate the factors associated with the occurrence of and recovery from transient urinary incontinence (TUI) after holmium laser enucleation of the prostate (HoLEP).

Materials and Methods: From March 2009 to December 2012, 391 consecutive patients treated with HoLEP for benign prostatic hyperplasia were enrolled. Information regarding age, prostate volume, International Prostate Symptom Score, Overactive Bladder Symptom Score, peak urinary flow rate, postvoid residual urine, and operation time was collected. TUI was defined as a patient complaint of urine leakage, regardless of type. Logistic regression was used to investigate the factors associated with the occurrence of TUI, and the Kaplan-Meier test was used to analyze the TUI recovery period.

Results: TUI after HoLEP occurred in 65 patients (16.6%), 52 patients of whom (80.0%) showed recovery within three months. Stress and urge urinary incontinence and postvoid dribbling occurred in 16 patients (4.1%), 29 patients (7.4%), and 33 patients (8.4%), respectively. Age (odds ratio [OR]=3.494; 95% confidence interval [CI]=1.565∼7.803; p=0.002) and total operation time (OR=3.849; 95% CI=1.613∼9.185; p=0.002) were factors that significantly affected the occurrence of TUI. Conclusions: TUI, defined as any type of urine leakage, occurred after HoLEP in some patients, most of whom recovered within three months. Stress urinary incontinence occurred in only 4% of patients after HoLEP. Age and total operation time were associated with the occurrence of postoperative TUI.