Is pre-operative urodynamic bladder function the true predictor of outcome of male sling for post prostatectomy incontinence?
| Autor: | Sachin Malde, Lap Yan Leung, Tamsin Greenwell, Jeremy Ockrim, Davendra Sharma, Raveen Saigal, Arun Sahai, Claire Taylor, Bogdan Toia, Eskinder Solomon, Jai Seth, Rizwan Hamid |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Nephrology
Male medicine.medical_specialty Male sling Urology Urinary Bladder 030232 urology & nephrology Post prostatectomy 03 medical and health sciences 0302 clinical medicine Postoperative Complications Predictive Value of Tests Internal medicine Statistical significance medicine Humans Aged Retrospective Studies Aged 80 and over Prostatectomy Suburethral Slings 030219 obstetrics & reproductive medicine Stress urinary incontinence business.industry Incidence (epidemiology) Prostatic Neoplasms Urodynamic Men Middle Aged Pre operative Surgery Urodynamics medicine.anatomical_structure Treatment Outcome Urinary Incontinence Preoperative Period Sphincter Original Article Bladder function business |
| Zdroj: | World Journal of Urology |
| ISSN: | 1433-8726 |
| Popis: | Purpose To investigate pre-operative urodynamic parameters in male sling patients to ascertain whether this might better predict surgical outcomes and facilitate patient selection. Methods We performed a retrospective, case notes and video-urodynamics, review of men who underwent AdVanceXP male sling in three London hospitals between 2012 and 2019. Urodynamics were performed in all centres, while retrograde leak point pressure (RLPP) was performed in one centre. Results Successful outcome was seen in 99/130 (76%) of men who required one pad or less per day. The dry rate was 51%. Pad usage was linked to worse surgical outcomes, mean 2.6 (range 1–6.5) for success vs 3.6 (range 1–10) although the ranges were wide (p = 0.002). 24 h pad weight also reached statistical significance (p = 0.05), with a mean of 181 g for success group versus 475 g for the non-successful group. The incidence of DO in the non-successful group was significantly higher than in successful group (55% versus 29%, p = 0.0009). Bladder capacity less than 250 ml was also associated with worse outcomes (p = 0.003). Reduced compliance was not correlated with outcomes (31% for success groups vs 45% for non-successful group, p = 0.15). Preoperative RLPP was performed in 60/130 patients but did not independently reach statistical significance (p = 0.25). Conclusion Urodynamic parameters related to bladder function—detrusor overactivity and reduced maximum cystometric capacity predict male sling outcomes and may help in patient selection for male sling (or sphincter) surgery; whereas urodynamic parameters of sphincter incompetency (RLPP) were not predictive. Further larger scale studies are required to confirm these findings. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
https://openaccess.sgul.ac.uk/id/eprint/112157/1/Toia2020_Article_IsPre-operativeUrodynamicBladd.pdf
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