{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T07:14:43Z","timestamp":1785654883468,"version":"3.56.0"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T00:00:00Z","timestamp":1736380800000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["LUTS"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>During holmium laser enucleation of the prostate (HOLEP), blunt dissection (BD) by pushing the tip of the scope may exert mechanical force on the sphincter that could be avoided by adopting laser dissection (LD). This study evaluates the continence recovery in consecutive patients who underwent BD and LD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective cohort of patients who underwent LD was compared with a retrospective control that underwent BD. In both groups, early apical release was performed, and the adenoma was split at 12 O'clock after complete enucleation. In LD, a trans\u2010capsular plane was sharply created by LD and is guided by the circular capsular fibers. A mechanical push with the resectoscope tip was used to create and maintain the ideal surgical plane in the BD group while the laser energy was used to achieve timely hemostasis. The primary outcome was stress urinary incontinence (SUI), defined as the need to use any number of pads, immediately after catheter removal, at 1\u2009week and 1\u2009month postoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Consecutive 51 (48.6%) and 54 (51.4%) patients underwent BD and LD, respectively. The LD group tends to be older while other demographics were comparable. Both groups were comparable regarding the estimated prostate volume, enucleation time, and postoperative resolution of symptoms. Continence recovery was in favor of the LD group immediately after removing the catheter (77.8% vs. 43.1%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), at 1\u2009week (92.6% vs. 66.7%; <jats:italic>p<\/jats:italic>\u2009=\u20090.002), with no significant difference at 1\u2009month (98.1% vs. 88.2%; <jats:italic>p<\/jats:italic>\u2009=\u20090.06).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>LD tends to have favorable early continence recovery compared with BD mostly because of less mechanical stress. Minimizing the periods of blunt pushes during the enucleation might benefit continence recovery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/luts.70006","type":"journal-article","created":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T23:59:22Z","timestamp":1736467162000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Laser\u2010Driven Dissection Achieves Earlier Continence Recovery Than Blunt Dissection During Holmium Laser Enucleation of the Prostate"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8902-517X","authenticated-orcid":false,"given":"Ahmed M.","family":"Harraz","sequence":"first","affiliation":[{"name":"Farwaniya Hospital  Farwaniya Kuwait"},{"name":"Sabah Al Ahmad Urology Center  Kuwait City Kuwait"},{"name":"Urology and Nephrology Center Mansoura University  Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saad","family":"Aldousari","sequence":"additional","affiliation":[{"name":"Sabah Al Ahmad Urology Center  Kuwait City Kuwait"},{"name":"Department of Surgery (Division of Urology), Faculty of Medicine Kuwait University  Kuwait City Kuwait"},{"name":"Department of Urology The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdelrahman I.","family":"Eltafahny","sequence":"additional","affiliation":[{"name":"Sabah Al Ahmad Urology Center  Kuwait City Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Almoumen","sequence":"additional","affiliation":[{"name":"Farwaniya Hospital  Farwaniya Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awad","family":"Thahir","sequence":"additional","affiliation":[{"name":"Farwaniya Hospital  Farwaniya 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