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Related Experiment Video

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Photoselective Vaporesection of the Prostate via an End-firing Lithium Triborate Crystal Laser
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Does Preoperative Bladder Compliance Affect Long-Term Functional Outcomes after Laser Prostatectomy?

Sangjun Yoo1, Hyeon Jeong1, Hwancheol Son1

  • 1Department of Urology, SMG-SNU Boramae Medical Center, Seoul, Korea.

The World Journal of Men'S Health
|April 29, 2023
PubMed
Summary

Laser prostatectomy significantly improves storage symptoms in men with severely reduced bladder compliance (<12.5 mL/cmH2O) long-term. This indicates laser prostatectomy is a viable treatment for these patients.

Keywords:
ComplianceLaserProstatectomyProstatic hyperplasiaUrinary bladder

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Area of Science:

  • Urology
  • Surgical Oncology
  • Lower Urinary Tract Symptoms

Background:

  • Laser prostatectomy is a common treatment for benign prostatic hyperplasia.
  • Preoperative bladder compliance may influence functional outcomes after surgery.
  • Storage symptoms are a key concern for patients undergoing prostatectomy.

Purpose of the Study:

  • To evaluate the impact of preoperative bladder compliance on long-term functional outcomes after laser prostatectomy.
  • To specifically assess changes in postoperative storage symptoms.
  • To identify patient subgroups who may benefit most from laser prostatectomy.

Main Methods:

  • Analysis of 1,608 men undergoing laser prostatectomy (2008-2014).
  • Patients stratified into three groups based on baseline bladder compliance (<12.5, 12.5-25, ≥25 mL/cmH2O).
  • Multivariable analysis to determine the association between bladder compliance and functional outcomes.

Main Results:

  • Lower bladder compliance (<12.5 mL/cmH2O) correlated with higher baseline International Prostate Symptom (IPSS) storage sub-scores.
  • Patients with <12.5 mL/cmH2O showed superior improvement in IPSS total and storage sub-scores at 12 and 36 months post-surgery.
  • Decreased bladder compliance (<12.5 mL/cmH2O) was significantly associated with better storage symptom improvement at 36 months.

Conclusions:

  • Laser prostatectomy leads to significant long-term improvement in storage symptoms for men with severely reduced bladder compliance (<12.5 mL/cmH2O).
  • This suggests laser prostatectomy is a suitable treatment option for patients experiencing severe bladder dysfunction.
  • Preoperative bladder compliance is a crucial factor in predicting storage symptom resolution post-laser prostatectomy.