{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T23:52:05Z","timestamp":1791589925734,"version":"4.3.4"},"reference-count":37,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T00:00:00Z","timestamp":1785628800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Endourology"],"published-print":{"date-parts":[[2026,11,1]]},"abstract":"\n Background:<\/jats:title>\n Holmium laser enucleation of prostate (HoLEP) is a size-independent procedure for benign prostatic obstruction. However, the predictors of various complications are poorly defined in the literature.<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n We propose a standardized framework for reporting postenucleation complications using a modified Clavien\u2013Dindo (CD) classification. We aim to identify predictors of postoperative complications following HoLEP within this unified framework, integrating both patient- and procedure-related variables.<\/jats:p>\n <\/jats:sec>\n \n Methodology:<\/jats:title>\n We retrospectively analyzed a prospectively collected database of patients undergoing HoLEP. Complications were stratified according to a modified CD classification framework developed for HoLEP. Predictors were analyzed using multinomial regression, and a heatmap was generated to identify correlations among predictors.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n A total of 855 patients were included in the study. The median prostate volume was 102 cc. Minor complications were seen in 513 patients (60%), most frequently transient incontinence (37.4%). Major complications occurred in 46 patients (5.4%), primarily bladder neck stenosis (2%) and urethral stricture (2%). Multivariate analysis showed that advancing age (odds ratio [OR] 1.03;\n p<\/jats:italic>\n = 0.008), recurrent urinary retention (OR 1.60;\n p<\/jats:italic>\n = 0.003), elevated body mass index (BMI) (OR 1.04;\n p<\/jats:italic>\n = 0.017), Anticoagulation use (OR 1.44;\n p<\/jats:italic>\n = 0.029) and longer operative duration (OR 1.004;\n p<\/jats:italic>\n = 0.002) were independent predictors of minor complications. Major complications were associated with smaller prostates (OR 0.93,\n p<\/jats:italic>\n = 0.016). Spearman\u2019s correlation showed that postoperative incontinence was correlated with advanced age (\n r<\/jats:italic>\n = 0.090,\n p<\/jats:italic>\n < 0.01), high BMI (\n r<\/jats:italic>\n = 0.082,\n p<\/jats:italic>\n < 0.05), and longer surgical duration (\n r<\/jats:italic>\n = 0.119,\n p<\/jats:italic>\n < 0.01). Prostate volume was negatively correlated with postoperative inability to void (\n r<\/jats:italic>\n = \u22120.107,\n p<\/jats:italic>\n < 0.01), bladder neck stenosis (\n r<\/jats:italic>\n = \u22120.107,\n p<\/jats:italic>\n < 0.01), and urethral stricture (\n r<\/jats:italic>\n = \u22120.102,\n p<\/jats:italic>\n < 0.01). Gross hematuria was correlated with anticoagulation use (\n r<\/jats:italic>\n = 0.101,\n p<\/jats:italic>\n < 0.01) and BMI (\n r<\/jats:italic>\n = 0.114,\n p<\/jats:italic>\n < 0.01), although neither factor predicted major complications.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n We proposed a standardized framework for reporting complications following endoscopic enucleation of the prostate. Our study also identified predictors of post-HoLEP major and minor complications.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/08927790261473192","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T05:07:41Z","timestamp":1785733661000},"page":"1213-1221","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["A Modified Clavien\u2013Dindo Framework and a Heatmap Analysis to Identify Predictors of Complications After Endoscopic Enucleation of the Prostate"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1376-810X","authenticated-orcid":false,"given":"Gurpremjit","family":"Singh","sequence":"first","affiliation":[{"name":"Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hasim","family":"Bakbak","sequence":"additional","affiliation":[{"name":"Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Abdelaziz","sequence":"additional","affiliation":[{"name":"Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikita D.","family":"Sharma","sequence":"additional","affiliation":[{"name":"Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan E.","family":"Katz","sequence":"additional","affiliation":[{"name":"Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Marcovich","sequence":"additional","affiliation":[{"name":"Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4273-5502","authenticated-orcid":false,"given":"Hemendra N.","family":"Shah","sequence":"additional","affiliation":[{"name":"Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,2]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/08927790251360022"},{"key":"e_1_3_4_3_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2023.0196"},{"key":"e_1_3_4_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2012.11.027"},{"key":"e_1_3_4_5_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2019.0630"},{"key":"e_1_3_4_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-010-0566-y"},{"key":"e_1_3_4_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000032691"},{"key":"e_1_3_4_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2022.07.047"},{"key":"e_1_3_4_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10103-023-03866-3"},{"key":"e_1_3_4_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2026.1791612"},{"key":"e_1_3_4_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-020-03156-5"},{"key":"e_1_3_4_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/cnr2.1672"},{"key":"e_1_3_4_13_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2019.0430"},{"key":"e_1_3_4_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/08927790261461243"},{"key":"e_1_3_4_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2017.12.065"},{"key":"e_1_3_4_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2007.06867.x"},{"key":"e_1_3_4_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000000280"},{"key":"e_1_3_4_18_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2020.0605"},{"key":"e_1_3_4_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-017-2071-z"},{"key":"e_1_3_4_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-020-03272-2"},{"key":"e_1_3_4_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-017-2159-5"},{"issue":"5","key":"e_1_3_4_22_1","first-page":"11650","article-title":"Aquablation versus TURP: 5-year outcomes of the WATER randomized clinical trial for prostate volumes 50-80 mL","volume":"30","author":"Oumedjbeur K","year":"2023","unstructured":"21.Oumedjbeur K, , Corsi NJ, , Bouhadana D, et al. Aquablation versus TURP: 5-year outcomes of the WATER randomized clinical trial for prostate volumes 50-80 mL. Can J Urol 2023;30(5):11650\u201311658.","journal-title":"Can J Urol"},{"key":"e_1_3_4_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-019-1153-8"},{"key":"e_1_3_4_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2024.10.070"},{"key":"e_1_3_4_25_1","doi-asserted-by":"publisher","DOI":"10.5534\/wjmh.2015.33.2.88"},{"key":"e_1_3_4_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2023.09.002"},{"issue":"3","key":"e_1_3_4_27_1","first-page":"44","article-title":"Holmium laser enucleation of the prostate (HoLEP): Size-independent gold standard for surgical management of benign prostatic hyperplasia","volume":"27","author":"Das AK","year":"2020","unstructured":"26.Das AK, , Han TM, , Hardacker TJ. Holmium laser enucleation of the prostate (HoLEP): Size-independent gold standard for surgical management of benign prostatic hyperplasia. 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