Can We Predict Which Patients will Experience Resolution of Detrusor Overactivity after Transurethral Resection of the Prostate?

Antunes, Alberto A.; Iscaife, Alexandre; Reis, Sabrina T.; Albertini, Aline; Nunes, Marco Antônio Prado; Lucon, Antônio Marmo; Nahas, William Carlos

doi:10.1016/j.juro.2014.12.095

Cited by 44 publications

(47 citation statements)

References 18 publications

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“…also showed that advanced patient age together with low MCC and early and high amplitude uninhibited contractions are the most important clinical predictors of persistent DO after BOO is relieved. 17 The results were similar to our results.…”

Section: Discussionsupporting

confidence: 92%

Can the lower urinary tract storage symptoms be completely resolved after plasmakinetic enucleation of the prostate?

Chen

Xin

et al. 2017

Asian J Androl

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The aim of this study was to determine whether the lower urinary tract storage symptoms of benign prostatic obstruction (BPO) could be completely resolved after plasmakinetic enucleation of the prostate (PKEP) and the possible predictors of persistent symptoms. Two hundred and sixty-seven cases of BPO performed PKEP from July 2008 to June 2009 were retrospectively analyzed. Five-year postoperative data were collected and compared with the preoperative data. According to the urodynamic results, the patients were divided into involuntary detrusor contraction (IDC) group (n = 95) and no IDC group (n = 172) preoperatively; the patients with IDC were divided into IDC-persistent group (n = 33) and IDC-resolved group (n = 62) after PKEP. The predictors of persistent IDC were analyzed. Compared with the preoperative data, the 5-year postoperative data showed that the IDC rate was lower (P = 0.000), Overactive Bladder Symptom Score (OABSS) was lower (P = 0.000), maximum cystometric capacity (MCC) was larger (P = 0.000), Prostate volume (PV) was smaller (P = 0.000), and prostate-specific antigen (PSA) was lower (P = 0.000). Compared with the no IDC group, the IDC group showed that the age was older (P = 0.016), MCC was smaller (P = 0.004), PSA was higher (P = 0.016), and Chronic Inflammation rate was higher (P = 0.004). Compared with IDC-resolved group after PKEP, IDC-persistent group showed that the age was older (P = 0.019), MCC was smaller (P = 0.000), PSA was higher (P = 0.013), and Chronic Inflammation rate was higher (P = 0.032). The present study shows that the storage symptoms are still needed to be focused on after PKEP. The advanced patient age, MCC, PSA, and chronic inflammation may be the important clinical predictors of persistent IDC.

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Section: Discussionsupporting

confidence: 92%

Can the lower urinary tract storage symptoms be completely resolved after plasmakinetic enucleation of the prostate?

Chen

Xin

et al. 2017

Asian J Androl

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“…Classification of DO may be according to its onset, amplitude, and recurrence during filling cystometry. Urodynamic risk factors for persistent DOA include Kageyama type I or II DO (early onset or phasic), amplitude >40 cmH 2 O, and maximum cystometric capacity <250 mL) . Clinical factors have also been related to persistent DO/OAB postoperatively (eg advanced age) …”

Section: Discussionmentioning

confidence: 99%

“…More recently, Antunes et al studied 46 patients with BPO who underwent TURP from 2011 to 2012. Urodynamics were carried out preoperatively and 12 months postoperatively.…”

Section: Introductionmentioning

confidence: 99%

Can we predict the success of prostatic surgery for male lower urinary tract symptoms: ICI‐RS 2018?

Wachter

Hervé

Averbeck

2019

Neurourology and Urodynamics

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Aims: Male lower urinary tract symptoms (LUTS) are common and bothersome symptoms in the aging population, of which the etiology is multifactorial.Prostatic surgery may be considered to alleviate some of these LUTS, especially in patients in which benign prostatic obstruction is believed to be the underlying cause. The aim of this paper is to discuss underlying pathophysiology, signs, and conditions that may lead to success or failure after prostatic surgery in male patients with LUTS. Methods: The paper is a report of presentations and subsequent discussions at the annual International Consultation on Incontinence Research Society, in June 2018 in Bristol.Results and conclusions: Unfavorable outcomes after prostatic surgery are reported in 25% to 30% of the patients. This may be due to persistent or de novo symptoms, related to the multifactorial origin of symptoms. Specific underlying conditions such as with detrusor overactivity, detrusor underactivity, and nocturnal polyuria are discussed in their relationship with prostatic surgery.Knowledge gaps are addressed and specific research questions proposed. K E Y W O R D Sdetrusor overactivity, detrusor under activity, male lower urinary tract symptoms, nocturia, overactive bladder, prostatic surgery, urodynamics

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“…This de novo urge incontinence causes significant stress and anxiety not only for the patients but also for the surgeons. In a recent prospective study of persistent storage symptoms after successful relief of BOO, urodynamic DO was persistent in approximately 40% of the patients [6].…”

Section: Introductionmentioning

confidence: 98%

The effect of a free radical scavenger on oxidation stress in partial bladder outlet obstruction and its relief in a rat model

Choo

Piao

2018

Preprint

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AIMS: To investigate the effect of a free radical scavenger (tempol) after relief of partial bladder outlet obstruction (pBOO) on bladder function in a rat model. METHODS: pBOO was induced in 50 eight-week-old female Sprague-Dawley rats and relieved 3 weeks later. The rats were divided randomly into 5 groups: sham-operated, tempol-treated for 1 week (Treat-1w) or 3 weeks (Treat-3w), and no treatment for 1 week (nonTreat-1w) or 3 weeks (nonTreat-3w).Awaken cystometrograms were obtained 1 or 3 weeks after relief according to the grouping. The bladders were isolated and weighed. H&E, Masson's trichrome and TUNEL staining were used to analyze histological changes. The oxidative stress assessed using malondialdehyde. The expression of beta-3 adrenoreceptor was examined by Western blotting. RESULTS:The tempol-treated groups exhibited a significant decrease in the number of IDCs per voiding cycle (nonTreat-1w vs. Treat-1w, 1.18±0.82 vs. 0.36±0.40, P=0.010; nonTreat-3w vs. Treat-3w, 1.51±0.69 vs. 0.23±0.25, P=0.002). The thickness and collagen fiber deposition of the detrusor muscle layer was significantly decreased in the treated groups. Apoptosis detected was mainly observed in the urothelial cell layer, although the rate of apoptosis was significantly decreased in the treated groups (48.9±3.36% vs. 32.7±11.10%, P=0.024; 25.8±4.67% vs. 15.7±9.83%, P=0.314). The tempol-treated groups showed significant decreases in the MDA concentrations at both 1 and 3 weeks after relief. The expression of the beta-3 adrenoreceptor was increased in the tempol-treated rats.CONCLUSIONS: Ischemic reperfusion injury after relief of pBOO caused histological and functional changes in the bladder. Free radical scavenger treatment prevented this oxidative stress.

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Can We Predict Which Patients will Experience Resolution of Detrusor Overactivity after Transurethral Resection of the Prostate?

Abstract: Advanced patient age together with low maximum cystometric capacity, and early and high detrusor overactivity amplitude are the most important predictors of persistent detrusor overactivity after relief of bladder outlet obstruction.

Cited by 44 publications

References 18 publications

Can the lower urinary tract storage symptoms be completely resolved after plasmakinetic enucleation of the prostate?

Can the lower urinary tract storage symptoms be completely resolved after plasmakinetic enucleation of the prostate?

Can we predict the success of prostatic surgery for male lower urinary tract symptoms: ICI‐RS 2018?

The effect of a free radical scavenger on oxidation stress in partial bladder outlet obstruction and its relief in a rat model

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