Introduction
Lower urinary tract symptoms (LUTS) due to benign prostate hyperplasia
(BPH) rapidly increase as men age1,
2. In the United States, over 100,000
patients with BPH annually undergo surgical treatment to alleviate LUTS3 despite advancements
in medical treatment and widespread usage of medications4.
Although conventional
transurethral prostatectomy (TURP) has remained the cornerstone of
surgical treatment for BPH, laser enucleation or vaporization are
regarded as alternative treatment options although prostate volume and
patient condition need to be considered for selecting treatment methods5.
However, even after surgical treatment, a considerable proportion of
patients with BPH still continues medical treatment due to the remaining
LUTS 6. In this regard,
accurate prediction of surgical outcomes and proper patient selection
are considered as one of the most important steps for BPH surgery.
Consequently, numerous studies have evaluated the predictors for better
functional outcomes after laser prostatectomy in BPH patients7,
8. However, despite these advancements in
the preoperative patient evaluation and selection, there were still
concerns about the remaining storage symptoms after surgical treatment
for BPH 9. In addition,
storage symptoms did not improve as much as voiding symptoms after
surgical treatment for BPH10, and some studies
have reported that storage symptoms did not improve as much after laser
prostatectomy than conventional TURP11,
12.
In this regard, several studies have evaluated the impacts of conditions
related to storage symptoms on the functional outcomes after BPH surgery13.
However, currently, there is no reliable method for predicting changes
in postoperative storage symptoms after laser surgery. In this current
clinical situation, a urodynamic study (UDS) could be a viable option
for predicting remained storage symptoms after laser surgery although
current guidelines only recommend a urodynamic study (UDS) in selected
situations 5,
14. In addition to detrusor
overactivity, bladder compliance is a well-known parameter derived from
UDS and reported to be related to storage function of the bladder15. However, the impact
of bladder compliance on the changes in the functional outcomes after
laser prostatectomy have been barely studied.
Thus, we assessed the effects of
bladder compliance on the long-term functional outcomes after laser
prostatectomy in patients with BPH, with a focus on storage symptoms.