MP27-03 PREDICTION OF URGE URINARY INCONTINENCE (UUI) AFTER HOLMIUM LASER ENUCLEATION OF PROSTATE (HOLEP): REVISITING THE URODYNAMIC DETRUSOR OVERACTIVITY (DO)

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology II1 Apr 2017MP27-03 PREDICTION OF URGE URINARY INCONTINENCE (UUI) AFTER HOLMIUM LASER ENUCLEATION OF PROSTATE (HOLEP): REVISITING THE URODYNAMIC DETRUSOR OVERACTIVITY (DO) Myong Kim, Tai Young Ahn, and Myung-Soo Choo Myong KimMyong Kim More articles by this author , Tai Young AhnTai Young Ahn More articles by this author , and Myung-Soo ChooMyung-Soo Choo More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.795AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Recent recommendation of international continence society (ICS, 2002) suggested the qualification of urodynamic DO as according to their pattern (phasic or terminal) or causes (neurogenic or idiopathic). However, quantification of DO has not been suggested. It is well known that there are some discordances between urodynamic DO and actual storage symptoms such as UUI. We assessed whether the quantification of urodynamic DO can improve the prediction of post-operative UUI following the HoLEP in patients with benign prostatic hyperplasia. METHODS We prospectively measured the filling volume at DO (Vol_DO), detrusor pressure at DO (PdetDO), and presence or absence of DO incontinence, in addition to the ICS recommendations for urodynamic study (UDS) in 105 patients who underwent HoLEP between May 2010 and September 2015. RESULTS Mean age (±SD) and prostate volume were 71.1 (±7.0) years and 63.7 (±24.2) mL. Of the 105 patients, 10 (9.5%) patients experienced the UUI at post-operative 3 months. The UUI-positive group demonstrated higher international prostate symptom score (IPSS)-storage (11.4 vs. 7.5, p=0.004) than the UUI-negative group. However, other parameters such as age, prostate size, preoperative uroflometry findings, IPSS-emptying, and IPSS-QoL were not significantly different between two groups (p range, 0.062-0.797). On UDS findings, UUI-positive group showed higher PdetDO than UUI-negative group (100.4 vs. 54.7 cmH2O, p=0.008). However, rates of DO presence and DO_vol were not significantly different between two groups (p-value, 0.423 and 0.788). DO incontinence is more frequent in UUI-positive group than in UUI-negative group, but failed to reach the statistical significance (80.0 vs. 52.6%, p=0.098). Spline curve analysis results suggested the optimal cut-off value of PdetDO for increased risk of UUI as 108.0 cmH2O (Figure). Our multivariate analysis revealed that pre-operative IPSS-storage (OR=1.696, p=0.036) and PdetDO (≥108.0 cmH2O; OR=15.546, p=0.044) were independent predictive factors for UUI after HoLEP. CONCLUSIONS Quantification of urodynamic DO improved the prediction of UUI after HoLEP © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e328-e329 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Myong Kim More articles by this author Tai Young Ahn More articles by this author Myung-Soo Choo More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...