Predictive Factors of De Novo Overactive Bladder After Artificial Urinary Sphincter Implantation in Men With Postprostatectomy Incontinence

Abstract

To investigate the rates and predictive factors associated with the development of de novo overactive bladder (OAB) and to assess the effects of de novo OAB on surgical outcomes after an artificial urinary sphincter (AUS). We performed a retrospective review of 132 patients with postprostatectomy incontinence who underwent AUS surgery. Urodynamic studies were performed during preoperative visits in all patients, and patients with OAB or neurogenic bladder were excluded. We assessed the development of de novo OAB based on patient symptoms. Treatment success was defined as no need for pads, and social continence was defined as the need for ≤1pad per day at the end of the follow-up. A multivariate analysis was performed using a logistic regression model to assess predictors of de novo OAB. The rate of development of de novo OAB after surgery was 37.5%. The treatment success rate was significantly higher in the no-OAB group (72.4%) than in the de novo OAB group (55.4%) (P = .038). A low preoperative cystometric capacity of less than 300 mL (odds ratio 5.27, confidence interval 1.02-27.28; P = .048) and pelvic irradiation (odds ratio 3.18, confidence interval 1.01-10.03; P = .049) were predictive factors of de novo OAB after AUS surgery. De novo OAB occurs commonly after AUS surgery, and the presence of de novo OAB adversely impacts treatment success. Low preoperative cystometric capacity of less than 300 mL and pelvic irradiation predict the occurrence of de novo OAB after AUS implantation.