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KMID : 1037120230410030734
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The World Journal of Men′s Health
2023 Volume.41 No. 3 p.734 ~ p.742
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Does Preoperative Bladder Compliance Affect Long-Term Functional Outcomes after Laser Prostatectomy?
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Yoo Sang-Jun
Jeong Hyeon
Son Hwan-Cheol
Oh Seung-June
Paick Jae-Seung
Cho Min-Chul
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Abstract
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Purpose : We assessed the effects of preoperative bladder compliance on the long-term functional outcomes, especially focused on postoperative storage symptom changes, after laser prostatectomy.
Materials and Methods : 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/cmH2O. A multivariable analysis was performed to determine the impact of bladder compliance on changes in long-term functional outcomes after laser prostatectomy.
Results : Bladder compliance was less than 12.5 mL/cmH2O in 50 (3.1%), 12.5?25 mL/cmH2O 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/cmH2O group compared to other groups, although those were equivalent at postoperative 1 months. On the multivariable analysis, decreased bladder compliance <12.5 mL/cmH2O was significantly associated with superior improvement in storage sub-score at postoperative 36 months, although it was not associated with voiding sub-score.
Conclusions : In patients with preoperative bladder compliance <12.5 mL/cmH2O, 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.
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KEYWORD
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Compliance, Laser, Prostatectomy, Prostatic hyperplasia, Urinary bladder
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