Does Postoperative Leukocyturia Influence Treatment Outcomes after Photoselective Vaporization of the Prostate (PVP)? A Prospective Short-Term Serial Follow-Up Study

Objective To identify serial changes in the incidence of leukocyturia after photoselective laser-vaporization of the prostate (PVP), to determine whether postoperative leukocyturia could be associated with surgical outcomes, and to identify predictors of persistent leukocyturia after PVP. Patients and Methods A total of 102 men without leukocyturia on baseline urinalysis but underwent PVP were included in this prospective study. Treatment outcomes were assessed at 1 week, and 1, 3, 6, and 12 months postoperatively using International Prostate Symptom Score, Overactive Bladder Symptom Score (OABSS), uroflowmetry, postvoid residual, urinalysis, urine culture, and serum prostate-specific antigen (PSA). Results The incidences of leukocyturia and dysuria at 1 week, and 1, 3, and 6 months postoperatively were 100.0%, 51.0%, 19.6%, and 0.0% and 30.3%, 25.4%, 5.9%, and 0.0%, respectively. Only one case of bacteriuria occurred throughout the entire follow-up period. At 1 month postoperatively, decrease in subtotal storage symptoms score, quality-of-life index, and total OABSS in patients without leukocyturia were significantly greater than in those with leukocyturia. At 3 months postoperatively, patients without leukocyturia showed greater improvement in subtotal storage symptoms score, total OABSS, quality-of-life index, bladder voiding efficiency, and postvoid residual compared with those with leukocyturia. On logistic regression analysis, age, PSA, prostate size, and amount of energy utilized were independent predictors of persistent leukocyturia 3 months after surgery. Conclusion Leukocyturia is observed in all patients immediately after PVP, but its incidence decreases with time. It may have adverse effects on treatment outcomes. Also, older age, higher serum PSA, larger prostate size, and greater amount of energy utilized may be risk factors of persistent leukocyturia.