Detrusor overactivity does not predict bothersome storage symptoms after photoselective vaporization of the prostate with lithium triborate laser.

Objective: To find out if detrusor overactivity (DO) is a predictor of moderate or severe storage lower urinary tract symptoms (LUTS) persisting 6 months after photoselective vaporization of the prostate (PVP).

Materials And Methods: Patients with bladder outlet obstruction proved by urodynamics who underwent PVP with the lithium triborate laser were followed for 6 months with the International Prostate Symptom Score (IPSS) questionnaire. Moderate-to-severe storage LUTS were defined as IPSS storage domain score >8 and/or a score for an IPSS question on urgency >3. Predictive values of DO, IPSS domains, urgency, prostate volume, bladder outlet obstruction grade, and energy used were tested by logistic regression analysis.

Results: Seventy-six men at the age of 66.4 ± 6.8 years underwent PVP, including 36 (47.4%) with DO. Incidence of moderate or severe storage LUTS was decreasing from 60.5% to 48.7% at week 6 and 11.8% at month 6 postoperatively. At a univariate analysis, urgency score and storage domain score were significantly associated with bothersome storage LUTS at month 6. Multivariate analysis confirmed predictive value of preoperative urgency having an odds ratio of 5.7 (95% confidence interval, 1.41-23.16; P = .014). DO was not associated with the defined outcome.

Conclusion: In our group, DO was not useful in predicting persistent storage symptoms after PVP. Patients with severe preoperative urgency should be informed about a risk of such outcome.