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Does preoperative bladder compliance affect long-term functional outcomes after laser prostatectomy?
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  • Sangjun Yoo,
  • Min Chul Cho,
  • Min Soo Choo,
  • Sung Yong Cho,
  • Hyeon Jeong,
  • Hwancheol Son,
  • Seung-June Oh,
  • Jae-Seung Paick
Sangjun Yoo
Seoul National University Seoul Metropolitan Government Boramae Medical Center

Corresponding Author:[email protected]

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Min Chul Cho
Seoul National University Seoul Metropolitan Government Boramae Medical Center
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Min Soo Choo
SNU SMG Boramae Medical Center
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Sung Yong Cho
Seoul National University Hospital
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Hyeon Jeong
Seoul National University Seoul Metropolitan Government Boramae Medical Center
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Hwancheol Son
SNU SMG Boramae Medical Center
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Seung-June Oh
Seoul National University Hospital
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Jae-Seung Paick
Mediplex Sejong Hospital
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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
Jan 2020Published in The Journal of Sexual Medicine volume 17 issue 1 on pages S83. 10.1016/j.jsxm.2019.11.149