Association between detrusor overactivity and postoperative outcomes in patients undergoing male bone anchored perineal sling

Abstract

Purpose: In this study we determined if there was an association between the presence of preoperative detrusor overactivity and patient outcomes after bone anchored perineal sling.

Materials and methods: A total of 85 men underwent a male perineal sling procedure for urodynamically proven stress urinary incontinence. Preoperative history and physical examination were performed, and patients completed self-assessment questionnaires. Based on urodynamics patients were divided into 2 groups of those with and those without detrusor overactivity. Questionnaires including the Patient Global Impression of Improvement Scale were readministered postoperatively. Success was defined by the Patient Global Impression of Improvement as very much better or much better. Failure was defined by the responses of a little better, no change, a little worse or much worse. Successes and failures were compared to the presence of detrusor overactivity. Preoperative parameters, preoperative and postoperative questionnaire scores, and postoperative pad and anticholinergic use were compared between the 2 groups.

Results: A total of 72 patients were included in the analysis, and of these 22 (30.6%) had detrusor overactivity and 50 (69.4%) did not. All patients completed the Patient Global Impression of Improvement. There was no statistical difference in the number of cases classified as successes or failures in the 2 groups (p = 0.4213). A significantly higher percentage of patients with detrusor overactivity required postoperative anticholinergics. There was no statistical difference in the number of patients using pads postoperatively.

Conclusions: Preoperative detrusor overactivity was not associated with worse postoperative outcomes. Men with urodynamic stress urinary incontinence and detrusor overactivity may be considered for a male sling procedure. However, they may require postoperative anticholinergics and should be counseled accordingly.