Bladder capacity on preoperative urodynamics may impact outcomes on transobturator male slings

被引:18
|
作者
Warner, Jonathan N. [1 ]
Grimsby, Gwen M. [1 ]
Tyson, Mark D. [1 ]
Wolter, Christopher E. [1 ]
机构
[1] Mayo Clin, Dept Urol, Phoenix, AZ USA
关键词
artificial urinary sphincter (AUS); body mass index (BMI); detrusor overactivity (DO); external urethral sphincter (EUS); intrinsic sphincter deficiency (ISD); post-prostatectomy incontinence (PPI); post void residual (PVR); stress urinary incontinence (SUI); transobturator sling (TOS); urodynamics (UDS); urinary retention (UR); valsalva leak point pressure (VLPP); POSTRADICAL PROSTATECTOMY INCONTINENCE; ARTIFICIAL URINARY SPHINCTER; POSTPROSTATECTOMY INCONTINENCE; RADICAL PROSTATECTOMY; TRANSURETHRAL RESECTION; MANAGEMENT; PATHOPHYSIOLOGY; PARAMETERS; MORBIDITY; DETRUSOR;
D O I
10.1002/nau.22233
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Aims Stress incontinence is frequently seen after prostate surgery. We sought to evaluate preoperative urodynamic (UDS) parameters on functional outcomes after transobturator male sling placement. Methods 49 male patients with stress urinary incontinence (SUI) after radical prostatectomy or transurethral resection of the prostate underwent transobturator sling (TOS) placement from December 2008 through June 2011 (AdVance (R) and Virtue (R)). A retrospective review was performed of those patients who underwent preoperative UDS and had a minimum of 6 weeks of follow up. In total 38 patients were identified. There were 28 patients considered a success and 10 patients considered a failure. We then evaluated the preoperative UDS parameters between these two groups to identify potential adverse parameters. Results Overall success rate was 74% (28/38) with an average follow up of 3 months. Comparing the success and failure groups there was no difference between the pre-operative parameters. On pre-operative UDS, only bladder capacity was found to be significantly lower in those who failed TOS. Univariate comparisons of sling outcomes stratified by bladder capacity tertiles was performed. These values were chosen as they represented the 25th, 50th, and 75th percentiles, respectively. All patients (10/10) with bladder capacities in the top tertile experienced success with the sling, compared to only 62% and 50% of patients in the 50th and 25th tertiles, respectively; these differences were significant (Fisher's exact P-value?=?0.044). Conclusion TOS is an effective therapy for men with SUI. Bladder capacity based on pre-operative UDS may impact the success of the procedure. Neurourol. Urodynam. 31:11241127, 2012. (c) 2012 Wiley Periodicals, Inc.
引用
收藏
页码:1124 / 1127
页数:4
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