Bladder capacity on preoperative urodynamics may impact outcomes on transobturator male slings

Jonathan N. Warner, Gwen M. Grimsby, Mark D. Tyson, Christopher E. Wolter

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Aims Stress incontinence is frequently seen after prostate surgery. We sought to evaluate preoperative urodynamic (UDS) parameters on functional outcomes after transobturator male sling placement. Methods 49 male patients with stress urinary incontinence (SUI) after radical prostatectomy or transurethral resection of the prostate underwent transobturator sling (TOS) placement from December 2008 through June 2011 (AdVance® and Virtue®). A retrospective review was performed of those patients who underwent preoperative UDS and had a minimum of 6 weeks of follow up. In total 38 patients were identified. There were 28 patients considered a success and 10 patients considered a failure. We then evaluated the preoperative UDS parameters between these two groups to identify potential adverse parameters. Results Overall success rate was 74% (28/38) with an average follow up of 3 months. Comparing the success and failure groups there was no difference between the pre-operative parameters. On pre-operative UDS, only bladder capacity was found to be significantly lower in those who failed TOS. Univariate comparisons of sling outcomes stratified by bladder capacity tertiles was performed. These values were chosen as they represented the 25th, 50th, and 75th percentiles, respectively. All patients (10/10) with bladder capacities in the top tertile experienced success with the sling, compared to only 62% and 50% of patients in the 50th and 25th tertiles, respectively; these differences were significant (Fisher's exact P-value = 0.044). Conclusion TOS is an effective therapy for men with SUI. Bladder capacity based on pre-operative UDS may impact the success of the procedure. Neurourol. Urodynam. 31:1124-1127, 2012. © 2012 Wiley Periodicals, Inc.

Original languageEnglish (US)
Pages (from-to)1124-1127
Number of pages4
JournalNeurourology and Urodynamics
Volume31
Issue number7
DOIs
StatePublished - Sep 2012

Fingerprint

Suburethral Slings
Urodynamics
Urinary Bladder
Stress Urinary Incontinence
Transurethral Resection of Prostate
Prostatectomy
Prostate

Keywords

  • artificial urinary sphincter (AUS)
  • body mass index (BMI)
  • detrusor overactivity (DO)
  • external urethral sphincter (EUS)
  • intrinsic sphincter deficiency (ISD)
  • post void residual (PVR)
  • post-prostatectomy incontinence (PPI)
  • stress urinary incontinence (SUI)
  • transobturator sling (TOS)
  • urinary retention (UR)
  • urodynamics (UDS)
  • valsalva leak point pressure (VLPP)

ASJC Scopus subject areas

  • Clinical Neurology
  • Urology

Cite this

Bladder capacity on preoperative urodynamics may impact outcomes on transobturator male slings. / Warner, Jonathan N.; Grimsby, Gwen M.; Tyson, Mark D.; Wolter, Christopher E.

In: Neurourology and Urodynamics, Vol. 31, No. 7, 09.2012, p. 1124-1127.

Research output: Contribution to journalArticle

Warner, Jonathan N. ; Grimsby, Gwen M. ; Tyson, Mark D. ; Wolter, Christopher E. / Bladder capacity on preoperative urodynamics may impact outcomes on transobturator male slings. In: Neurourology and Urodynamics. 2012 ; Vol. 31, No. 7. pp. 1124-1127.
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abstract = "Aims Stress incontinence is frequently seen after prostate surgery. We sought to evaluate preoperative urodynamic (UDS) parameters on functional outcomes after transobturator male sling placement. Methods 49 male patients with stress urinary incontinence (SUI) after radical prostatectomy or transurethral resection of the prostate underwent transobturator sling (TOS) placement from December 2008 through June 2011 (AdVance{\circledR} and Virtue{\circledR}). A retrospective review was performed of those patients who underwent preoperative UDS and had a minimum of 6 weeks of follow up. In total 38 patients were identified. There were 28 patients considered a success and 10 patients considered a failure. We then evaluated the preoperative UDS parameters between these two groups to identify potential adverse parameters. Results Overall success rate was 74{\%} (28/38) with an average follow up of 3 months. Comparing the success and failure groups there was no difference between the pre-operative parameters. On pre-operative UDS, only bladder capacity was found to be significantly lower in those who failed TOS. Univariate comparisons of sling outcomes stratified by bladder capacity tertiles was performed. These values were chosen as they represented the 25th, 50th, and 75th percentiles, respectively. All patients (10/10) with bladder capacities in the top tertile experienced success with the sling, compared to only 62{\%} and 50{\%} of patients in the 50th and 25th tertiles, respectively; these differences were significant (Fisher's exact P-value = 0.044). Conclusion TOS is an effective therapy for men with SUI. Bladder capacity based on pre-operative UDS may impact the success of the procedure. Neurourol. Urodynam. 31:1124-1127, 2012. {\circledC} 2012 Wiley Periodicals, Inc.",
keywords = "artificial urinary sphincter (AUS), body mass index (BMI), detrusor overactivity (DO), external urethral sphincter (EUS), intrinsic sphincter deficiency (ISD), post void residual (PVR), post-prostatectomy incontinence (PPI), stress urinary incontinence (SUI), transobturator sling (TOS), urinary retention (UR), urodynamics (UDS), valsalva leak point pressure (VLPP)",
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T1 - Bladder capacity on preoperative urodynamics may impact outcomes on transobturator male slings

AU - Warner, Jonathan N.

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AU - Tyson, Mark D.

AU - Wolter, Christopher E.

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N2 - Aims Stress incontinence is frequently seen after prostate surgery. We sought to evaluate preoperative urodynamic (UDS) parameters on functional outcomes after transobturator male sling placement. Methods 49 male patients with stress urinary incontinence (SUI) after radical prostatectomy or transurethral resection of the prostate underwent transobturator sling (TOS) placement from December 2008 through June 2011 (AdVance® and Virtue®). A retrospective review was performed of those patients who underwent preoperative UDS and had a minimum of 6 weeks of follow up. In total 38 patients were identified. There were 28 patients considered a success and 10 patients considered a failure. We then evaluated the preoperative UDS parameters between these two groups to identify potential adverse parameters. Results Overall success rate was 74% (28/38) with an average follow up of 3 months. Comparing the success and failure groups there was no difference between the pre-operative parameters. On pre-operative UDS, only bladder capacity was found to be significantly lower in those who failed TOS. Univariate comparisons of sling outcomes stratified by bladder capacity tertiles was performed. These values were chosen as they represented the 25th, 50th, and 75th percentiles, respectively. All patients (10/10) with bladder capacities in the top tertile experienced success with the sling, compared to only 62% and 50% of patients in the 50th and 25th tertiles, respectively; these differences were significant (Fisher's exact P-value = 0.044). Conclusion TOS is an effective therapy for men with SUI. Bladder capacity based on pre-operative UDS may impact the success of the procedure. Neurourol. Urodynam. 31:1124-1127, 2012. © 2012 Wiley Periodicals, Inc.

AB - Aims Stress incontinence is frequently seen after prostate surgery. We sought to evaluate preoperative urodynamic (UDS) parameters on functional outcomes after transobturator male sling placement. Methods 49 male patients with stress urinary incontinence (SUI) after radical prostatectomy or transurethral resection of the prostate underwent transobturator sling (TOS) placement from December 2008 through June 2011 (AdVance® and Virtue®). A retrospective review was performed of those patients who underwent preoperative UDS and had a minimum of 6 weeks of follow up. In total 38 patients were identified. There were 28 patients considered a success and 10 patients considered a failure. We then evaluated the preoperative UDS parameters between these two groups to identify potential adverse parameters. Results Overall success rate was 74% (28/38) with an average follow up of 3 months. Comparing the success and failure groups there was no difference between the pre-operative parameters. On pre-operative UDS, only bladder capacity was found to be significantly lower in those who failed TOS. Univariate comparisons of sling outcomes stratified by bladder capacity tertiles was performed. These values were chosen as they represented the 25th, 50th, and 75th percentiles, respectively. All patients (10/10) with bladder capacities in the top tertile experienced success with the sling, compared to only 62% and 50% of patients in the 50th and 25th tertiles, respectively; these differences were significant (Fisher's exact P-value = 0.044). Conclusion TOS is an effective therapy for men with SUI. Bladder capacity based on pre-operative UDS may impact the success of the procedure. Neurourol. Urodynam. 31:1124-1127, 2012. © 2012 Wiley Periodicals, Inc.

KW - artificial urinary sphincter (AUS)

KW - body mass index (BMI)

KW - detrusor overactivity (DO)

KW - external urethral sphincter (EUS)

KW - intrinsic sphincter deficiency (ISD)

KW - post void residual (PVR)

KW - post-prostatectomy incontinence (PPI)

KW - stress urinary incontinence (SUI)

KW - transobturator sling (TOS)

KW - urinary retention (UR)

KW - urodynamics (UDS)

KW - valsalva leak point pressure (VLPP)

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