Effect of Preoperative Urodynamic Detrusor Underactivity on Transurethral Surgery for Benign Prostatic Hyperplasia: A Systematic Review and Meta-Analysis

Myong Kim, Chang Wook Jeong, Seung June Oh

Research output: Contribution to journalArticlepeer-review

32 Scopus citations

Abstract

Purpose We investigated the effect of preoperative urodynamic detrusor underactivity on the transurethral surgery outcomes of benign prostatic hyperplasia. Materials and Methods We systematically searched the online PubMed®, Embase® and Cochrane Library databases for articles published between January 1989 and June 2017. Results A total of 10 articles met the eligibility criteria for this systematic review. The eligible studies included a total of 1,113 patients with a median of 73 per study (range 40 to 382). Five of the 10 studies involved conventional transurethral prostatectomy and 5 described laser surgery. In patients with detrusor underactivity the pooled mean difference was significant for the poorer I-PSS (International Prostate Symptom Score) (pooled mean difference −3.73, 95% CI −5.65–−1.80 for 9 studies and 936 participants) and maximal flow rate improvement (pooled mean difference −3.92, 95% CI −4.85–−3.00 for 8 studies and 951 participants) but not for quality of life score (pooled mean difference −0.15, 95% CI −0.56–0.25 for 7 studies and 858 participants) or post-void residual volume (pooled mean difference −5.57, 95% CI −20.65–9.50 for 9 studies and 971 participants). Some comparisons showed interstudy heterogeneity despite strict selection criteria for the included studies. However, there was no clear evidence of publication bias in this meta-analysis. Conclusions Our meta-analysis results showed that preoperative detrusor underactivity correlated with poorer I-PSS and maximal flow rate improvement. Preoperative urodynamic detrusor underactivity is a valuable finding for excluding patients who are inappropriate candidates for transurethral surgery.

Original languageEnglish
Pages (from-to)237-244
Number of pages8
JournalJournal of Urology
Volume199
Issue number1
DOIs
StatePublished - Jan 2018

Keywords

  • muscle hypertonia
  • prostate
  • prostatic hyperplasia
  • urethra
  • urodynamics

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