{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T07:02:35Z","timestamp":1779692555467,"version":"3.53.1"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the clinical efficacy and safety of biofeedback electrical stimulation combined with holmium laser enucleation of the prostate (HoLEP) in the treatment of patients with benign prostatic hyperplasia (BPH) complicated by detrusor underactivity (DUA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective analysis was conducted on 100 patients with BPH and DUA who had surgical indications and were treated in the Department of Urology of our hospital from January 2023 to June 2025. Patients were divided into an intervention group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200951) and a control group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200949) according to the treatment modality they received. Patients in the intervention group underwent HoLEP followed by biofeedback electrical stimulation therapy (three times per week for a total of 10 sessions), whereas those in the control group received HoLEP alone. The International Prostate Symptom Score (IPSS), Quality of Life score (QOL), maximum urinary flow rate (Qmax), bladder contractility index (BCI), bladder outlet obstruction index (BOOI), maximum detrusor pressure (Pdetmax), post-void residual volume (PVR), voiding efficiency (VE), and postoperative complications were compared between the two groups before surgery and at 3 months postoperatively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline characteristics were comparable between the two groups (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;gt;\u20090.05). At 3 months postoperatively, the intervention group showed significantly higher Qmax (14.38\u2009\u00b1\u20091.47\u2005mL\/s vs. 10.01\u2009\u00b1\u20090.85\u2005mL\/s,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) and BCI (111.68\u2009\u00b1\u200910.15 vs. 93.96\u2009\u00b1\u20098.42,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), significantly lower IPSS (10.8\u2009\u00b1\u20091.9 vs. 18.6\u2009\u00b1\u20092.1,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) and QOL scores (2.1\u2009\u00b1\u20090.8 vs. 3.0\u2009\u00b1\u20090.6,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), significantly lower PVR (21.8\u2009\u00b1\u20095.8\u2005mL vs. 40.2\u2009\u00b1\u20097.5\u2005mL,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), and significantly higher VE (77.8\u2009\u00b1\u20096.2% vs. 61.9\u2009\u00b1\u20095.8%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) compared with the control group. The proportion of patients achieving Qmax \u226515\u2005mL\/s at 3 months postoperatively was 39.2% in the intervention group vs. 20.8% in the control group (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.022). At 90 days postoperatively, the incidence rates of urinary tract infection (13.7% vs. 28.6%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.047), urinary incontinence (9.8% vs. 24.5%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.039), and indwelling catheter reinsertion (2.0% vs. 12.2%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.037) were significantly lower in the intervention group than in the control group. No significant differences were observed in the incidence of postoperative bleeding or urethral stricture between the two groups (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;gt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Biofeedback electrical stimulation combined with HoLEP significantly improves voiding function, clinical symptoms, and quality of life in patients with BPH and DUA, enhances bladder contractility, and reduces the risk of postoperative complications, offering clear clinical benefits and a favorable safety profile, warranting broader clinical adoption.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1847062","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T06:04:29Z","timestamp":1779689069000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of biofeedback electrical stimulation combined with HoLEP on surgical outcomes in patients with benign prostatic hyperplasia complicated with detrusor underactivity: a retrospective cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Tengfei","family":"Gu","sequence":"first","affiliation":[{"name":"Department of Urology, Lishui Municiple Central Hospital, The Fifth Afliated Hospital of Wenzhou Medical University","place":["Lishui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology, Lishui Municiple Central Hospital, The Fifth Afliated Hospital of Wenzhou Medical University","place":["Lishui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Urology, Lishui Municiple Central Hospital, The Fifth Afliated Hospital of Wenzhou Medical University","place":["Lishui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongtao","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Urology, Lishui Municiple Central Hospital, The Fifth Afliated Hospital of Wenzhou Medical University","place":["Lishui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinzhou","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Urology, Lishui Municiple Central Hospital, The Fifth Afliated Hospital of Wenzhou Medical University","place":["Lishui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Sha","sequence":"additional","affiliation":[{"name":"Department of Nursing, Lishui Municiple Central Hospital, The Fifth Afliated Hospital of Wenzhou Medical University","place":["Lishui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1186\/s12894-025-01715-9","article-title":"Global, regional, and national burden of benign prostatic hyperplasia from 1990 to 2021 and projection to 2035","volume":"25","author":"Wei","year":"2025","journal-title":"BMC Urol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1097\/MOU.0000000000000246","article-title":"Detrusor underactivity in men with lower urinary tract symptoms\/benign prostatic obstruction: characterization and potential impact on indications for surgical treatment of the prostate","volume":"26","author":"Rademakers","year":"2016","journal-title":"Curr Opin Urol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"59","DOI":"10.23736\/S2724-6051.20.03678-4","article-title":"Detrusor overactivity and underactivity: implication for lower urinary tract symptoms related to benign prostate hyperplasia diagnosis and treatment","volume":"73","author":"Creta","year":"2021","journal-title":"Minerva Urol Nephrol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1016\/j.urology.2015.11.052","article-title":"Impact of detrusor underactivity on surgical outcomes of Laser prostatectomy: comparison in serial 12-month follow-up outcomes between potassium-titanyl-phosphate photoselective vaporization of the prostate (PVP) and holmium Laser enucleation of the prostate (HoLEP)","volume":"91","author":"Cho","year":"2016","journal-title":"Urology"},{"key":"B5","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1590\/s1677-5538.ibju.2021.0687","article-title":"Is biofeedback-assisted pelvic floor muscle training superior to pelvic floor muscle training alone in the treatment of dysfunctional voiding in women? 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