Urodynamic characteristics and clinical significance of detrusor overactivity in early (≤6 months) male urinary incontinence following TURP and RARP: a descriptive analysis of two cohorts
TL;DR
In both groups, the presence of DO was associated with reduced MCC and BC, suggesting that DO is a clinically relevant factor affecting storage-phase function regardless of surgical type.
Abstract
Background To describe the urodynamic features of early (≤6 months) male urinary incontinence after transurethral resection of the prostate (TURP) and robot-assisted radical prostatectomy (RARP) as two separate cohorts, and to evaluate the clinical significance of detrusor overactivity (DO) within each group, thereby providing descriptive evidence to support tailored diagnosis and treatment strategies. Methods A retrospective analysis was conducted using data from patients diagnosed with early (≤6 months) urinary incontinence (UI) after TURP or RARP. Urodynamic parameters, including maximum cystometric capacity (MCC), first desire to void (FD), strong desire to void (SD), bladder compliance (BC), abdominal leak point pressure (ALPP), and the presence of detrusor overactivity (DO), were analyzed within each cohort.Subgroup analyses based on DO status were performed separately for each group. The severity of UI was assessed using the International Consultation on Incontinence Questionnaire-Short Form (ICI-Q-SF). Results A total of 51 patients in the TURP+UI group and 38 patients in the RARP+UI group were included. The TURP+UI group showed significantly higher MCC [260 (207-301) vs 217 (154.50-274.50) mL, P=0.02] and FD (152.78 ± 57.52 vs 123.95 ± 65.65 mL, P=0.03), and lower ICI-Q-SF scores [10 (6-16) vs 19 (17-20), P<0.00] compared to the RARP+UI group. DO was observed in 27.45% of TURP+UI patients and 39.47% of RARP+UI patients. In both groups, patients with DO exhibited significantly lower MCC, FD, SD, and BC values(P<0.00). In the RARP+UI group, patients with DO also had significantly lower ALPP values [0 (0–44) vs 58 (43–91) cmH2O, P<0.001]. Partial correlation analysis revealed that ICI-Q-SF scores were negatively associated with MCC (r=–0.34, p=0.02) and SD (r=[–0.34, p=0.02) in the TURP+UI group, and with ALPP (r=–0.60, p<0.00) in the RARP +UI group. Conclusion This study describes the urodynamic characteristics of patients with early (≤6 months) UI following TURP and those with UI after RARP as two separate cohorts. In both groups, the presence of DO was associated with reduced MCC and BC, suggesting that DO is a clinically relevant factor affecting storage-phase function regardless of surgical type. The distinct urodynamic profiles observed between the two cohorts likely reflect differences in underlying pathology and surgical mechanisms. Due to the absence of preoperative urodynamic data, these findings should be interpreted as descriptive phenotypic characterizations rather than comparative evidence.