Surgical Outcomes and Predictive Factors in Patients With Detrusor Underactivity Undergoing Bladder Outlet...

Area of Science:

• Urology
• Surgical Innovation
• Lower Urinary Tract Symptoms

Background:

• Detrusor underactivity (DU) presents challenges in managing lower urinary tract symptoms (LUTS).
• The role of bladder outlet surgery in DU patients with or without obstruction requires further clarification.
• Identifying predictors of surgical success is crucial for patient selection and management.

Purpose of the Study:

• To evaluate the efficacy of bladder outlet surgery in men with detrusor underactivity (DU).
• To identify factors associated with successful surgical outcomes in this patient group.
• To assess the impact of bladder outlet obstruction (BOO) on surgical results for DU.

Main Methods:

• Retrospective review of 93 male patients with DU undergoing bladder outlet surgery.
• Assessment using International Prostate Symptom Score (IPSS), uroflowmetry (UFM), and urodynamic studies.
• Successful outcomes defined by ≥50% IPSS improvement or regaining spontaneous voiding.

Main Results:

• Significant improvements in IPSS, maximum urine flow rate, and voiding efficiency were observed in patients with significant or equivocal bladder outlet obstruction (BOO).
• Patients without obstruction showed no significant improvements in IPSS or UFM.
• Detrusor overactivity and preoperative urinary catheterization were associated with favorable outcomes (OR 3.152, P=0.025 and OR 2.756, P=0.040, respectively).

Conclusions:

• Bladder outlet surgery can improve LUTS, quality of life, and UFM in men with DU and BOO.
• Patients with DU and an unobstructed bladder outlet have a higher risk of treatment failure.
• Preoperative detrusor overactivity and catheterization predict better surgical outcomes, supporting deobstructive surgery for urinary retention in DU patients.