TAIPEI, TAIWAN (UroToday.com) - Introduction and Objectives: Over the past decade, there has been a dramatic shift in endoscopic treatment of lower urinary tract symptoms (LUTS) favoring laser technologies. Urinary incontinence (UI) after laser surgery has not been described.
Methods: Retrospective cohort of 55 men (mean age 67) who underwent Greenlight laser prostatectomy for BPH. We administered International Prostatic Symptoms Score (IPSS) and Michigan Incontinence Symptom Index (MISI) at baseline (preoperatively) and after the surgery. We estimated the incidence, severity, and bother, of incontinence using the MISI at 1 and 6 months after surgery.We then fitted multivariable regression model to examine the factors associated with the change in UI.
Results: MISI scores at baseline, 1 month and 6 month after surgery demonstrates slight increase in UI at 1 month and then an average UI that is lower than baseline at 6 months. Urge urinary incontinence (MISI-UUI) was predominant before surgery. The proportion of patients who had the minimally importance difference (MID) at 6 months after the surgery is 16%, 12%, 10%, and 3% for the total severity, UUI, SUI, and bother domains, respectively. Adjusted regression found higher baseline MISIUUI and IPSS obstructive domain score (r = 0.4, p = 0.008) to be predictive of a change in UI.
Conclusions: UI was present at baseline but improved by 6 months. Although 16% of the patients had the MID of urinary incontinence, only 3% were bothered by their symptoms. Greater MISI-UUI score and obstructive symptoms at baseline were both associated with less UI after surgery.
Source of Funding: None
|Listen to an interview with Abdulrahman Alruwaily, one of the authors of this study.|
Presented by Abdulrahman Alruwaily, Rabia Siddiqui, Maggie Bierlein, Heather Crossley, Sara Lenherr, and John Wei at the 32nd World Congress of Endourology & SWL - September 3 - 7, 2014 - Taipei, Taiwan
University of Michigan Medical School, Ann Arbor, MI USA