Does Preoperative Bladder Compliance Affect Long-Term Functional Outcomes after Laser Prostatectomy?

• Published in: The world journal of men's health Vol. 41; no. 3; pp. 734 - 742
• Main Authors: Yoo, Sangjun, Jeong, Hyeon, Son, Hwancheol, Oh, Seung-June, Paick, Jae-Seung, Cho, Min Chul
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society for Sexual Medicine and Andrology 01.07.2023
• Subjects: Bladder; Body mass index; Compliance; laser; Laser surgery; Original; Patients; Prostate; prostatectomy; prostatic hyperplasia; Questionnaires; Surgery; Surgical outcomes; urinary bladder; Urine; United States > US; Prostatectomy; Prostatic hyperplasia; Compliance; Urinary bladder; Laser
• ISSN: 2287-4208; 2287-4690
• DOI: 10.5534/wjmh.220081

We assessed the effects of preoperative bladder compliance on the long-term functional outcomes, especially focused on postoperative storage symptom changes, after laser prostatectomy. From January 2008 to March 2014, 1,608 men who underwent laser prostatectomy, including holmium laser enucleation or photo-vaporization of the prostate, were included in the analysis. We divided patients into 3 groups according to bladder compliance on a baseline urodynamic study: <12.5, 12.5-25, ≥25 mL/cmH O. A multivariable analysis was performed to determine the impact of bladder compliance on changes in long-term functional outcomes after laser prostatectomy. Bladder compliance was less than 12.5 mL/cmH O in 50 (3.1%), 12.5-25 mL/cmH O in 232 (14.4%) patients. As bladder compliance decreased, the baseline International Prostate Symptom (IPSS) total score and storage sub-score were increased; the voiding sub-score remain unchanged. At postoperative 12 and 36 months, absolute improvements in the IPSS total score and storage sub-score were higher in <12.5 mL/cmH O group compared to other groups, although those were equivalent at postoperative 1 months. On the multivariable analysis, decreased bladder compliance <12.5 mL/cmH O was significantly associated with superior improvement in storage sub-score at postoperative 36 months, although it was not associated with voiding sub-score. In patients with preoperative bladder compliance <12.5 mL/cmH O, storage symptoms could be further improved at 36 months after laser prostatectomy compared to others. Thus, laser prostatectomy could be a considerable treatment option for patients with severely decreased bladder compliance.