Does preoperative bladder compliance affect long-term functional
outcomes after laser prostatectomy?
Abstract
Introduction: 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, 1608 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; 12.5–25.0; ≥25 mL/cm H2O.
A multivariable analysis was performed to determine the impact of
bladder compliance on long-term functional outcomes after laser
prostatectomy. Results: Bladder compliance was less than 12.5 ml/cm H2O
in 50 (3.1%), 12.5-25 ml/cm H2O in 232 (14.4%) patients. As bladder
compliance decreased, the baseline International Prostate Symptom
(I-PSS) total score and storage sub-score were increased; the voiding
sub-score remain unchanged. At postoperative 36 months, improvements in
the I-PSS total score and storage sub-score were significantly higher in
< 12.5 mL/cm H2O group compared to other groups, although
those were equivalent at postoperative 1 and 12 months. On the
multivariable analysis, decreased bladder compliance < 12.5
mL/cm H2O was significantly associated with superior improvement in
storage sub-score at postoperative 36 months, although it was not
associated with voiding sub-score. Conclusion: In patients with
preoperative bladder compliance < 12.5 mL/cm H2O, 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