Surgical Outcomes and Predictive Factors in Patients With Detrusor Underactivity Undergoing Bladder Outlet Obstruction Surgery
Purpose This study was conducted to evaluate the efficacy of bladder outlet surgery in patients with detrusor underactivity (DU) and to identify factors associated with successful outcomes. Methods We conducted a retrospective review of men diagnosed with DU in urodynamic studies who underwent bladd...
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| Format: | Article |
| Language: | English |
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Korean Continence Society
2024-03-01
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| Series: | International Neurourology Journal |
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| Online Access: | http://einj.org/upload/pdf/inj-2346252-126.pdf |
| _version_ | 1797224473387073536 |
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| author | Ming-Syun Chuang Yin-Chien Ou Yu-Sheng Cheng Kuan-Yu Wu Chang-Te Wang Yuan-Chi Huang Yao-Lin Kao |
| author_facet | Ming-Syun Chuang Yin-Chien Ou Yu-Sheng Cheng Kuan-Yu Wu Chang-Te Wang Yuan-Chi Huang Yao-Lin Kao |
| author_sort | Ming-Syun Chuang |
| collection | DOAJ |
| description | Purpose This study was conducted to evaluate the efficacy of bladder outlet surgery in patients with detrusor underactivity (DU) and to identify factors associated with successful outcomes. Methods We conducted a retrospective review of men diagnosed with DU in urodynamic studies who underwent bladder outlet surgery for lower urinary tract symptoms between May 2018 and April 2023. The International Prostate Symptom Score (IPSS) questionnaire, uroflowmetry (UFM), and multichannel urodynamic studies were administered. Successful treatment outcomes were defined as either an IPSS improvement of at least 50% or the regaining of spontaneous voiding in patients urethral catheterization prior to surgery. Results The study included 93 male patients. Men diagnosed with significant or equivocal bladder outlet obstruction (BOO) experienced significant postoperative improvements in IPSS (from 20.6 to 6.0 and from 17.4 to 6.5, respectively), maximum urine flow rate (from 5.0 mL/sec to 14.4 mL/sec and from 8.8 mL/sec to 12.2 mL/sec, respectively) and voiding efficiency (from 48.8% to 86.0% and from 61.2% to 85.1%, respectively). However, in the group without obstruction, the improvements in IPSS and UFM results were not significant. The presence of detrusor overactivity (odds ratio [OR], 3.152; P=0.025) and preoperative urinary catheterization (OR, 2.756; P=0.040) were associated with favorable treatment outcomes. Conversely, an unobstructed bladder outlet was identified as a negative prognostic factor. Conclusions In men with DU accompanied by equivocal or significant BOO, surgical intervention to alleviate the obstruction may enhance the IPSS, quality of life, and UFM results. However, those with DU and an unobstructed bladder outlet face a comparatively high risk of treatment failure. Preoperative detrusor overactivity and urinary catheterization are associated with more favorable surgical outcomes. Consequently, active deobstructive surgery should be considered for patients with DU who are experiencing urinary retention. |
| first_indexed | 2024-04-24T13:53:41Z |
| format | Article |
| id | doaj.art-7cd4400f6bc045faaf50d5ded2fe0f5f |
| institution | Directory Open Access Journal |
| issn | 2093-4777 2093-6931 |
| language | English |
| last_indexed | 2024-04-24T13:53:41Z |
| publishDate | 2024-03-01 |
| publisher | Korean Continence Society |
| record_format | Article |
| series | International Neurourology Journal |
| spelling | doaj.art-7cd4400f6bc045faaf50d5ded2fe0f5f2024-04-04T00:09:27ZengKorean Continence SocietyInternational Neurourology Journal2093-47772093-69312024-03-01281596610.5213/inj.2346252.1261103Surgical Outcomes and Predictive Factors in Patients With Detrusor Underactivity Undergoing Bladder Outlet Obstruction SurgeryMing-Syun Chuang0Yin-Chien Ou1Yu-Sheng Cheng2Kuan-Yu Wu3Chang-Te Wang4Yuan-Chi Huang5Yao-Lin Kao6 Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanPurpose This study was conducted to evaluate the efficacy of bladder outlet surgery in patients with detrusor underactivity (DU) and to identify factors associated with successful outcomes. Methods We conducted a retrospective review of men diagnosed with DU in urodynamic studies who underwent bladder outlet surgery for lower urinary tract symptoms between May 2018 and April 2023. The International Prostate Symptom Score (IPSS) questionnaire, uroflowmetry (UFM), and multichannel urodynamic studies were administered. Successful treatment outcomes were defined as either an IPSS improvement of at least 50% or the regaining of spontaneous voiding in patients urethral catheterization prior to surgery. Results The study included 93 male patients. Men diagnosed with significant or equivocal bladder outlet obstruction (BOO) experienced significant postoperative improvements in IPSS (from 20.6 to 6.0 and from 17.4 to 6.5, respectively), maximum urine flow rate (from 5.0 mL/sec to 14.4 mL/sec and from 8.8 mL/sec to 12.2 mL/sec, respectively) and voiding efficiency (from 48.8% to 86.0% and from 61.2% to 85.1%, respectively). However, in the group without obstruction, the improvements in IPSS and UFM results were not significant. The presence of detrusor overactivity (odds ratio [OR], 3.152; P=0.025) and preoperative urinary catheterization (OR, 2.756; P=0.040) were associated with favorable treatment outcomes. Conversely, an unobstructed bladder outlet was identified as a negative prognostic factor. Conclusions In men with DU accompanied by equivocal or significant BOO, surgical intervention to alleviate the obstruction may enhance the IPSS, quality of life, and UFM results. However, those with DU and an unobstructed bladder outlet face a comparatively high risk of treatment failure. Preoperative detrusor overactivity and urinary catheterization are associated with more favorable surgical outcomes. Consequently, active deobstructive surgery should be considered for patients with DU who are experiencing urinary retention.http://einj.org/upload/pdf/inj-2346252-126.pdfdetrusor underactivitybladder outlet obstructionurodynamicsprostateoveractive detrusor |
| spellingShingle | Ming-Syun Chuang Yin-Chien Ou Yu-Sheng Cheng Kuan-Yu Wu Chang-Te Wang Yuan-Chi Huang Yao-Lin Kao Surgical Outcomes and Predictive Factors in Patients With Detrusor Underactivity Undergoing Bladder Outlet Obstruction Surgery International Neurourology Journal detrusor underactivity bladder outlet obstruction urodynamics prostate overactive detrusor |
| title | Surgical Outcomes and Predictive Factors in Patients With Detrusor Underactivity Undergoing Bladder Outlet Obstruction Surgery |
| title_full | Surgical Outcomes and Predictive Factors in Patients With Detrusor Underactivity Undergoing Bladder Outlet Obstruction Surgery |
| title_fullStr | Surgical Outcomes and Predictive Factors in Patients With Detrusor Underactivity Undergoing Bladder Outlet Obstruction Surgery |
| title_full_unstemmed | Surgical Outcomes and Predictive Factors in Patients With Detrusor Underactivity Undergoing Bladder Outlet Obstruction Surgery |
| title_short | Surgical Outcomes and Predictive Factors in Patients With Detrusor Underactivity Undergoing Bladder Outlet Obstruction Surgery |
| title_sort | surgical outcomes and predictive factors in patients with detrusor underactivity undergoing bladder outlet obstruction surgery |
| topic | detrusor underactivity bladder outlet obstruction urodynamics prostate overactive detrusor |
| url | http://einj.org/upload/pdf/inj-2346252-126.pdf |
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