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.