Mp09-05 Postoperative Urinary Incontinence Following BPH Surgery: Insights From a Comprehensive U.S. Database Analysis

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Epidemiology, Evaluation & Medical Non-surgical Therapy (MP09)1 May 2024MP09-05 POSTOPERATIVE URINARY INCONTINENCE FOLLOWING BPH SURGERY: INSIGHTS FROM A COMPREHENSIVE U.S. DATABASE ANALYSIS Leslie Claire Licari, Celeste Manfredi, Eugenio Bologna, Antonio Franco, Francesco Ditonno, Morgan Sturgis, Spencer Mossack, Cosimo De Nunzio, Alessandro Antonelli, Giuseppe Simone, Marco De Sio, Christopher Coogan, Sarah A. Adelstein, Edward E. Cherullo, and Riccardo Autorino Leslie Claire LicariLeslie Claire Licari , Celeste ManfrediCeleste Manfredi , Eugenio BolognaEugenio Bologna , Antonio FrancoAntonio Franco , Francesco DitonnoFrancesco Ditonno , Morgan SturgisMorgan Sturgis , Spencer MossackSpencer Mossack , Cosimo De NunzioCosimo De Nunzio , Alessandro AntonelliAlessandro Antonelli , Giuseppe SimoneGiuseppe Simone , Marco De SioMarco De Sio , Christopher CooganChristopher Coogan , Sarah A. AdelsteinSarah A. Adelstein , Edward E. CherulloEdward E. Cherullo , and Riccardo AutorinoRiccardo Autorino View All Author Informationhttps://doi.org/10.1097/01.JU.0001008920.55771.18.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Advancements in surgical techniques and technologies have expanded the therapeutic options available for treating benign prostatic hyperplasia (BPH). Our study aims to investigate the differences in Urinary Incontinence (UI) rates among patients undergoing BPH surgery. METHODS: We conducted a retrospective analysis of the PearlDiver™ Mariner database. It is a commercially available, all-payer claims, deidentified, U.S. database, containing over 41 billion Health Insurance HIPAA-compliant patient records collected between 2011 and 2022. Specific International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) codes were used to identify population and outcomes in the database. All the patients who underwent BPH surgery were analyzed, and were categorized by type of surgical procedure, age, and Charlson Comorbidity Index (CCI). Rates of Overall UI (OUI), Stress UI (SUI), Urge UI (UUI) and Mixed UI (MUI), within 12 months after surgery, were assessed. Multivariate regression analysis was used to identify potential predictors of postoperative incontinence. RESULTS: Among 274,808 patients who underwent BPH surgery, 11,017 (4.01%) experienced a form of postoperative UI. A significant proportion of these patients were diagnosed with UUI (58.67% of the total). SUI and MUI rates stood at 28.04% and 13.29%, respectively. When analyzing specific procedures, UUI rates varied between 0.62% (Prostate Artery Embolization - PAE) and 2.71% (Photoselective Vaporization of the Prostate - PVP), SUI ranged from 0.04% (PAE) and 2.67% (Laparoscopic/Robotic Simple Prostatectomy), while MUI between 0.11% (PAE) and 1.17% (Holmium/Thulium Laser Enucleation of the Prostate). On multivariable analysis, age (OR 1.007; CI: 1.004-1.009; p<0.001) and comorbidity index (OR 1.034; CI: 1.027-1.039; p<0.001) were statistically significant predictor of overall UI. Moreover, Holmium/Thulium Laser Enucleation of the Prostate (OR 1.612; CI: 0.848-1.721; p<0.001), PVP (OR 1.164; CI: 1.122-1.208; p<0.001), Open Simple Prostatectomy (OR 1.424; CI: 1.241-1.624; p<0.001), and Lap/RobSimple Prostatectomy (OR 1.667; CI: 1.119-2.384; p<0.01) showed significant higher risk of overall UI compared to Transurethral Resection of the Prostate (TURP). On the other hand, Prostatic Urethral Lift (OR 0.604; CI: 0.566-0.644; p<0.001), Rezum (OR 0.661; CI: 0.579-0.752; p<0.001), Aquablation (OR 0.434; CI: 0.216-0.767; p<;0.01), and PAE (OR 0.178; CI: 0.111-0.269; p<0.001) were associated with lower odds of UI compared to TURP. CONCLUSIONS: Postoperative UI remains a concerning complication following BPH surgery, but it is an uncommon event that affects less than 5% of patients. Some differences in UI rates might exist among various surgical modalities. These findings underscore the need for thorough patient selection and counseling. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e128 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Leslie Claire Licari More articles by this author Celeste Manfredi More articles by this author Eugenio Bologna More articles by this author Antonio Franco More articles by this author Francesco Ditonno More articles by this author Morgan Sturgis More articles by this author Spencer Mossack More articles by this author Cosimo De Nunzio More articles by this author Alessandro Antonelli More articles by this author Giuseppe Simone More articles by this author Marco De Sio More articles by this author Christopher Coogan More articles by this author Sarah A. Adelstein More articles by this author Edward E. Cherullo More articles by this author Riccardo Autorino More articles by this author Expand All Advertisement PDF downloadLoading ...