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You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology IV (MP62)1 May 2024MP62-16 THE UTILITY OF URODYNAMIC STUDIES IN PREDICTING VOIDING FUNCTION IN CATHETER-DEPENDENT PATIENTS AFTER HOLEP: A RETROSPECTIVE STUDY AT A TERTIARY CARE CENTER Cassie Schuster, Charles M. Ellis, Lila McGrath, Davis Temple, and Rebecca Gerber Cassie SchusterCassie Schuster , Charles M. EllisCharles M. Ellis , Lila McGrathLila McGrath , Davis TempleDavis Temple , and Rebecca GerberRebecca Gerber View All Author Informationhttps://doi.org/10.1097/01.JU.0001008904.63948.3b.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urinary retention is a known sequela of benign prostatic hyperplasia (BPH) with bladder outlet obstruction (BOO). The role of urodynamics (UDS) in the preoperative evaluation of catheter-dependent patients being considered for operative intervention of BPH remains unclear. Additionally, when undergoing UDS, a portion of these men may be deemed unobstructed based on the International Continence Society Nomogram (ICS) bladder outlet obstruction index (BOOI) due to decreased detrusor pressures and subsequently may not be considered for operative intervention. METHODS: A retrospective chart review was conducted for a prospectively-maintained database of individuals who underwent HoLEP between October 2021 – July 2023 by a single surgeon at a tertiary care center. Among the subset of patients who were catheter dependent preoperatively, data was stratified according to whether or not pressure-flow urodynamic testing was obtained. Statistical analysis employed T-tests and post-Tukey Hoc testing as appropriate, wherein a p<0.05 was considered significant. RESULTS: 75 patients were catheter-dependent preoperatively. The average time patients were catheter-dependent prior to surgery was 7.77 months (1-60 months). The success rate for initial trial of void (TOV) was 68.6% in individuals who underwent UDS preoperatively and 91.5% in individuals who did not (p=0.03). All patients had a successful TOV by postoperative day 14 and continued to void spontaneously at 3 month follow up. Of the 16 patients who underwent preoperative UDS, 37.5% were found to have bladder outlet obstruction (BOO) based on the BOOI, while 62.5% of patients had equivocal or unobstructed results. The average bladder contractility index (BCI) in the BOO group was 110, while the average BCI in the non-obstructed group was 48. There was not a statistically significant difference in successful TOV between patients who were found to have BOO and patients who did not (p=1). CONCLUSIONS: While AUA guidelines advise obtaining UDS in patients with catheter-dependent urinary retention who may have underactive detrusor function, the role of UDS remains unclear. While there was a statistically significant difference in successful initial TOV between the UDS and non UDS groups, our data supports that obtaining preoperative UDS is not predictive of voiding function after surgery in catheter-dependent patients outside the immediate postoperative period. Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1027 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Cassie Schuster More articles by this author Charles M. Ellis More articles by this author Lila McGrath More articles by this author Davis Temple More articles by this author Rebecca Gerber More articles by this author Expand All Advertisement PDF downloadLoading ...
Schuster et al. (Mon,) studied this question.