Predictors of short‐term overactive bladder symptom improvement after transurethral resection of prostate in men with benign prostatic obstruction

Abstract

OBJECTIVES: To investigate the correlation of preoperative overactive bladder symptoms and urodynamic parameters to the improvement of overactive bladder symptoms after transurethral resection of the prostate. METHODS: A retrospective study was carried out in 128 patients with urodynamically proven benign prostatic obstruction that underwent transurethral resection of the prostate. All patients had preoperative urgency symptoms. The patients were divided into groups according to overactive bladder symptom severity and preoperative urodynamic parameters (presence and type of detrusor overactivity, degree of obstruction, bladder contractility). The 3-month postoperative changes in overactive bladder symptoms were then compared between the groups. RESULTS: Overall, there was a statistically significant improvement in mean overactive bladder symptoms score from 9.6 to 2.7 (P < 0.001). However, patients with preoperative mild overactive bladder symptoms had significantly lower postoperative overactive bladder symptoms scores than those with moderate or severe symptoms (P < 0.05). Patients with preoperative terminal detrusor overactivity had significantly higher overactive bladder symptoms scores compared with patients with phasic and no detrusor overactivity (P < 0.05), and were more likely to have persistent urge incontinence. Preoperative detrusor contractility and severity of obstruction did not affect postoperative overactive bladder symptom improvement. CONCLUSIONS: Most patients with benign prostatic obstruction and overactive bladder symptoms experience an improvement in their symptoms after transurethral resection of the prostate. The presence of preoperative terminal detrusor overactivity might be negatively associated with this improvement. The preoperative severity of overactive bladder symptoms, detrusor contractility and degree of bladder outlet obstruction do not appear to have an effect.