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
Keywords : Compliance; Laser; Prostatic hyperplasia;
Prostatectomy; Urinary bladder