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

Abstract

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

Factors Influencing Postoperative Overactive Bladder after Adjustable Trans-Obturator Male System Implantation for Male Stress Incontinence following Prostatectomy

“…OAB is common in men undergoing prostatic surgery because bladder outlet obstruction produces changes in the bladder wall, both in the detrusor muscle and in the urothelium, thus resulting in OAB symptoms. The prevalence of OAB in men with benign prostatic enlargement is up to 60% before prostatic resection (TURP) and may persist in 30% to 50% after TURP [20]. On the other hand, the appearance of de novo OAB after prostate surgery is not infrequent.…”