Predictive Factors of De Novo Overactive Bladder after Artificial Urinary Sphincter Implantation in Men with Post-Prostatectomy Incontinence

To investigate the rates and predictive factors associated with the development of de novo overactive bladder (OAB) and assess the effects of de novo OAB on surgical outcomes after artificial urinary sphincter (AUS).

We performed a retrospective review of 132 post-prostatectomy incontinence patients who underwent AUS surgery. Urodynamic studies were performed during preoperative visits in all patients, and patients with OAB or neurogenic bladder were excluded. We assessed the development of de novo OAB based on patient symptoms. Treatment success was defined as no need per pads and social continence was defined as need for pad ≤1/day at the end of the follow-up. A multivariate analysis was performed using a logistic regression model to assess predictors of de novo OAB.

The rate of development de novo OAB after surgery was 37.5%. The treatment success rate was significantly higher in the no OAB group (72.4%) than the de novo OAB group (55.4%) (p=0.038). Low preoperative cystometric capacity less than 300ml (OR 5.27, CI 1.02-27.28; p=0.048) and pelvic irradiation (OR 3.18, CI 1.01-10.03; p=0.049) were predictive factors of de novo OAB after AUS surgery.

De novo OAB occurs commonly after AUS surgery and the presence of de novo OAB adversely impacts treatment success. Low preoperative cystometric capacity of less than 300ml and pelvic irradiation predict the occurrence of de novo OAB after AUS implantation.

Urology. 2017 Oct 10 [Epub ahead of print]

Kwang Jin Ko, Chung Un Lee, Tae Heon Kim, Yoon Seok Suh, Kyu-Sung Lee

Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea., Department of Urology, Center for Prostate Cancer, Research Institute and Hospital of the National Cancer Center, Goyang, Republic of Korea., Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea. Electronic address: .

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