Benign Prostatic HyperplasiaNCT07872085
Optimization of Surgical Treatment Pathways for BPH Based on Real-World Data
A study testing Conventional HoLEP Without Apical Pre-disconnection, HoLEP With Fixed 12 O'clock Apical Pre-disconnection and HoLEP With MRI-Guided Individualized Apical Pre-disconnection in people with Benign Prostatic Hyperplasia and Stress Urinary Incontinence (SUI), run by The First Affiliated Hospital with Nanjing Medical University at 1 site in China.
Trial summary
Benign prostatic hyperplasia is a noncancerous enlargement of the prostate that can cause difficulty urinating. Holmium laser enucleation of the prostate (HoLEP) uses a laser to remove prostate tissue blocking urine flow. Read more about this study
- Who is it for?
- Ages 50 to 85 years, men only
- Conditions the study is for
- Benign Prostatic Hyperplasia, Stress Urinary Incontinence (SUI)
- What is being tested?
- Conventional HoLEP Without Apical Pre-disconnection, HoLEP With Fixed 12 O'clock Apical Pre-disconnection and HoLEP With MRI-Guided Individualized Apical Pre-disconnection
- Type of treatment
- Pill or oral medicine, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 153 participants
- Where
- 1 siteChina
- Study dates
- 10 Mar 2026to 7 Sep 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 50 to 85 years
- Men only
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Men aged 50 to 85 years.
- Diagnosed with benign prostatic hyperplasia and scheduled to undergo holmium laser enucleation of the prostate (HoLEP).
- International Prostate Symptom Score (IPSS) ≥8.
- Maximum urinary flow rate (Qmax) <10 mL/s.
- Prostate volume ≥40 mL.
- Preoperative magnetic resonance imaging (MRI) available for anatomical assessment.
- Written informed consent provided before enrollment.
Who cannot join
- Neurogenic bladder.
- Urethral stricture.
- Pre-existing urinary incontinence.
- External urethral sphincter dysfunction.
- Active infection.
- Pelvic malignancy.
- Severe cognitive impairment.
Trial locations and contacts
1 site in 1 country.
China1 site
The First Affiliated Hospital with Nanjing Medical University (Jiangsu Province Hospital)
Nanjing, Jiangsu
About this study
Official title: Optimization of Surgical Treatment Pathways for Benign Prostatic Hyperplasia Based on Real-World Data
Benign prostatic hyperplasia is a noncancerous enlargement of the prostate that can cause difficulty urinating. Holmium laser enucleation of the prostate (HoLEP) uses a laser to remove prostate tissue blocking urine flow. Some patients experience stress urinary incontinence after surgery, meaning urine leakage during activities such as coughing, sneezing, or physical exertion. This may be related to temporary dysfunction or injury of the muscle that controls urine release.
This single-center, prospective randomized study compares three HoLEP techniques in men aged 50-85 years with benign prostatic hyperplasia: conventional HoLEP without apical pre-disconnection; HoLEP with apical pre-disconnection at a fixed 12 o'clock location; and HoLEP with MRI-guided individualized apical pre-disconnection. Apical pre-disconnection involves separating the urethral lining near the tip of the prostate before the main tissue removal step. In the individualized group, preoperative magnetic resonance imaging (MRI) is used to tailor the separation site to each patient's anatomy.
Read more
The study tests the hypothesis that MRI-guided individualized apical pre-disconnection reduces postoperative stress urinary incontinence and improves early urinary control and quality of life compared with the other two techniques, while maintaining the improvement in urination achieved by HoLEP.
Participants are randomly assigned to one of the three surgical groups and assessed at 1 week, 1 month, and 3 months after surgery. The primary outcome is the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF) total score at 3 months. This questionnaire measures the frequency and amount of urine leakage and its impact on daily life. Secondary outcomes include ICIQ-UI-SF scores at 1 week and 1 month, and quality of life, urinary symptoms, maximum urine flow rate, and postvoid residual urine volume at all three follow-up visits. Postoperative complications are also recorded and compared among groups.
- Being tested
- Conventional HoLEP Without Apical Pre-disconnection, HoLEP With Fixed 12 O'clock Apical Pre-disconnection, HoLEP With MRI-Guided Individualized Apical Pre-disconnection
- Medical subject headings
- Prostatic Hyperplasia, Urinary Incontinence, Stress
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Conventional HoLEP Without Apical Pre-disconnectionProcedure or surgery
Conventional en-bloc holmium laser enucleation of the prostate (HoLEP) is performed without apical pre-disconnection. After mucosal incision at the level of the verumontanum and bilateral exposure of the surgical capsule, the enlarged prostate tissue is enucleated along the capsule, released into the bladder, and morcellated for removal.
HoLEP With Fixed 12 O'clock Apical Pre-disconnectionProcedure or surgery
En-bloc holmium laser enucleation of the prostate (HoLEP) is performed with standardized apical pre-disconnection before enucleation. The initial pre-disconnection is made at the fixed 12 o'clock position corresponding to the projection of the verumontanum onto the urethral mucosa, without adjustment based on MRI-derived sphincter anatomy. Enucleation and morcellation are then completed.
HoLEP With MRI-Guided Individualized Apical Pre-disconnectionProcedure or surgery
En-bloc holmium laser enucleation of the prostate (HoLEP) is performed with apical pre-disconnection tailored to preoperative magnetic resonance imaging (MRI). MRI is used to assess the anatomical relationship between the 12 o'clock projection of the verumontanum (V point) and the endpoint of the external urethral sphincter (S point). For type A anatomy, pre-disconnection is performed at the V point. For type B anatomy, the pre-disconnection site is shifted 5 mm proximally toward the bladder neck. For type C anatomy, the proximal shift is individualized according to the MRI-measured distance between the V and S points. Enucleation and morcellation are then completed.
| Study group | Role | What they receive |
|---|---|---|
| Conventional HoLEP Without Apical Pre-disconnection | Active comparator | Not described Receives: Procedure: Conventional HoLEP Without Apical Pre-disconnection |
| HoLEP With Fixed 12 O'clock Apical Pre-disconnection | Active comparator | Not described Receives: Procedure: HoLEP With Fixed 12 O'clock Apical Pre-disconnection |
| HoLEP With MRI-Guided Individualized Apical Pre-disconnection | Experimental | Not described Receives: Procedure: HoLEP With MRI-Guided Individualized Apical Pre-disconnection |
What is being measured
The primary outcome is the main question the study is designed to answer.
International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF) Total Score
Urinary incontinence will be assessed using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF). The questionnaire measures the frequency and amount of urine leakage and its impact on daily life. The total score ranges from 0 to 21, with higher scores indicating more severe urinary incontinence and a greater impact on daily life. Total scores at 3 months after surgery will be compared among the three surgical groups.
Measured: 3 months after surgery
Secondary outcomes (5)
International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF) Total Score at Early Follow-up Visits
Urinary incontinence will be assessed using the ICIQ-UI-SF, which measures the frequency and amount of urine leakage and its impact on daily life. The total score ranges from 0 to 21, with higher scores indicating more severe urinary incontinence and a greater impact on daily life. Scores will be compared among the three surgical groups at each follow-up visit.
Measured: 1 week and 1 month after surgery
International Prostate Symptom Score (IPSS) Quality of Life Score
Quality of life related to urinary symptoms will be assessed using the single quality of life question accompanying the IPSS. Scores range from 0 (delighted) to 6 (terrible), with higher scores indicating worse quality of life related to urinary symptoms. Scores will be compared among the three surgical groups at each follow-up visit.
Measured: 1 week, 1 month, and 3 months after surgery
International Prostate Symptom Score (IPSS) Total Score
Lower urinary tract symptom severity will be assessed using the seven symptom questions of the IPSS. The total score ranges from 0 to 35, with higher scores indicating more severe urinary symptoms. Scores will be compared among the three surgical groups at each follow-up visit.
Measured: 1 week, 1 month, and 3 months after surgery
Maximum Urinary Flow Rate (Qmax)
Maximum urinary flow rate will be measured by uroflowmetry and reported in milliliters per second (mL/s). Measurements will be compared among the three surgical groups at each follow-up visit to evaluate urinary flow after surgery.
Measured: 1 week, 1 month, and 3 months after surgery
Postvoid Residual Urine Volume (PVR)
The volume of urine remaining in the bladder after urination will be measured and reported in milliliters (mL). Measurements will be compared among the three surgical groups at each follow-up visit to evaluate bladder emptying after surgery.
Measured: 1 week, 1 month, and 3 months after surgery
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Oct 2026
- Study start10 Mar 2026
- Primary completion7 Sep 2026
- Study completion7 Sep 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Benign Prostatic HyperplasiaStudies of the same condition, open and under way.
- More trials run by The First Affiliated Hospital with Nanjing Medical UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 153 participants (actual)
Sponsor and investigators
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07872085
- Sponsor's protocol ID
- 2026-SR-163
- Status last verified
- Jan 2026
- First submitted
- 7 Oct 2026
- Last updated
- 13 Oct 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 13 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Optimization of Surgical Treatment Pathways for Benign Prostatic Hyperplasia Based on Real-World Data
- ClinicalTrials.gov ID
- NCT07872085
- Acronym / sponsor ID
- 2026-SR-163
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 153 participants (actual)
- Lead sponsor
- The First Affiliated Hospital with Nanjing Medical UniversityUniversity, hospital or other
- Study start
- 10 Mar 2026 (actual)
- Primary completion
- 7 Sep 2026 (actual)
- Study completion
- 7 Sep 2026 (actual)
- First posted
- 13 Oct 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Benign prostatic hyperplasia is a noncancerous enlargement of the prostate that can cause difficulty urinating. Holmium laser enucleation of the prostate (HoLEP) uses a laser to remove prostate tissue blocking urine flow. Some patients experience stress urinary incontinence after surgery, meaning urine leakage during activities such as coughing, sneezing, or physical exertion. This may be related to temporary dysfunction or injury of the muscle that controls urine release.
This single-center, prospective randomized study compares three HoLEP techniques in men aged 50-85 years with benign prostatic hyperplasia: conventional HoLEP without apical pre-disconnection; HoLEP with apical pre-disconnection at a fixed 12 o'clock location; and HoLEP with MRI-guided individualized apical pre-disconnection. Apical pre-disconnection involves separating the urethral lining near the tip of the prostate before the main tissue removal step. In the individualized group, preoperative magnetic resonance imaging (MRI) is used to tailor the separation site to each patient's anatomy.
The study tests the hypothesis that MRI-guided individualized apical pre-disconnection reduces postoperative stress urinary incontinence and improves early urinary control and quality of life compared with the other two techniques, while maintaining the improvement in urination achieved by HoLEP.
Participants are randomly assigned to one of the three surgical groups and assessed at 1 week, 1 month, and 3 months after surgery. The primary outcome is the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF) total score at 3 months. This questionnaire measures the frequency and amount of urine leakage and its impact on daily life. Secondary outcomes include ICIQ-UI-SF scores at 1 week and 1 month, and quality of life, urinary symptoms, maximum urine flow rate, and postvoid residual urine volume at all three follow-up visits. Postoperative complications are also recorded and compared among groups.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Conventional HoLEP Without Apical Pre-disconnection | Active comparator | Procedure: Conventional HoLEP Without Apical Pre-disconnection |
| HoLEP With Fixed 12 O'clock Apical Pre-disconnection | Active comparator | Procedure: HoLEP With Fixed 12 O'clock Apical Pre-disconnection |
| HoLEP With MRI-Guided Individualized Apical Pre-disconnection | Experimental | Procedure: HoLEP With MRI-Guided Individualized Apical Pre-disconnection |
Who may qualify
- Ages
- 50 to 85 years
- Sex
- Male only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (7 listed)
- Men aged 50 to 85 years.
- Diagnosed with benign prostatic hyperplasia and scheduled to undergo holmium laser enucleation of the prostate (HoLEP).
- International Prostate Symptom Score (IPSS) ≥8.
- Maximum urinary flow rate (Qmax) <10 mL/s.
- Prostate volume ≥40 mL.
Key exclusion criteria (7 listed)
- Neurogenic bladder.
- Urethral stricture.
- Pre-existing urinary incontinence.
- External urethral sphincter dysfunction.
- Active infection.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Conventional HoLEP Without Apical Pre-disconnectionConventional en-bloc holmium laser enucleation of the prostate (HoLEP) is performed without apical pre-disconnection. After mucosal incision at the level of the verumontanum and bilateral exposure of the surgical capsule, the enlarged prostate tissue is enucleated along the capsule, released into the bladder, and morcellated for removal. | Procedure or surgery | Conventional HoLEP Without Apical Pre-disconnection |
| HoLEP With Fixed 12 O'clock Apical Pre-disconnectionEn-bloc holmium laser enucleation of the prostate (HoLEP) is performed with standardized apical pre-disconnection before enucleation. The initial pre-disconnection is made at the fixed 12 o'clock position corresponding to the projection of the verumontanum onto the urethral mucosa, without adjustment based on MRI-derived sphincter anatomy. Enucleation and morcellation are then completed. | Procedure or surgery | HoLEP With Fixed 12 O'clock Apical Pre-disconnection |
| HoLEP With MRI-Guided Individualized Apical Pre-disconnectionEn-bloc holmium laser enucleation of the prostate (HoLEP) is performed with apical pre-disconnection tailored to preoperative magnetic resonance imaging (MRI). MRI is used to assess the anatomical relationship between the 12 o'clock projection of the verumontanum (V point) and the endpoint of the external urethral sphincter (S point). For type A anatomy, pre-disconnection is performed at the V point. For type B anatomy, the pre-disconnection site is shifted 5 mm proximally toward the bladder neck. For type C anatomy, the proximal shift is individualized according to the MRI-measured distance between the V and S points. Enucleation and morcellation are then completed. | Procedure or surgery | HoLEP With MRI-Guided Individualized Apical Pre-disconnection |
Primary outcome
International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF) Total Score
Time frame: 3 months after surgery
Urinary incontinence will be assessed using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF). The questionnaire measures the frequency and amount of urine leakage and its impact on daily life. The total score ranges from 0 to 21, with higher scores indicating more severe urinary incontinence and a greater impact on daily life. Total scores at 3 months after surgery will be compared among the three surgical groups.
5 secondary outcomes
International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF) Total Score at Early Follow-up Visits
Time frame: 1 week and 1 month after surgery
International Prostate Symptom Score (IPSS) Quality of Life Score
Time frame: 1 week, 1 month, and 3 months after surgery
International Prostate Symptom Score (IPSS) Total Score
Time frame: 1 week, 1 month, and 3 months after surgery
Maximum Urinary Flow Rate (Qmax)
Time frame: 1 week, 1 month, and 3 months after surgery
Postvoid Residual Urine Volume (PVR)
Time frame: 1 week, 1 month, and 3 months after surgery
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 Oct 2026.
Related trials for Benign Prostatic Hyperplasia
Recruiting
Clinical Study on Prostate Thermal Vapor Ablation Guided by MRI/TRUS Fusion Imaging
Benign Prostatic Hyperplasia (BPH)
Active, not recruitingPhase 4
Standard Versus Double Alpha Blockers Treatment for Symptomatic Benign Prostatic Obstruction
BPH (Benign Prostatic Hyperplasia)
RecruitingObservational study
ProVIDE Studies Post Exit Analysis
BPH With Symptomatic Lower Urinary Tract Symptoms
Recruiting
Learning Curve of Tri-lobar HoLEP Versus En-bloc HoLEP
Benign Prostatic Hyperplasia With Outflow Obstruction
RecruitingObservational study
Impact of Long-term Dutasteride Use on Perioperative Outcomes of HoLEP
Prostatic Hyperplasia, Benign
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Conventional HoLEP Without Apical Pre-disconnection, HoLEP With Fixed 12 O'clock Apical Pre-disconnection and HoLEP With MRI-Guided Individualized Apical Pre-disconnection in people with Benign Prostatic Hyperplasia and Stress Urinary Incontinence (SUI), run by The First Affiliated Hospital with Nanjing Medical University at 1 site in China.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 7 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 13 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF) Total Score (time frame: 3 months after surgery). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Oct 2026.