title: Bladder capacity on preoperative urodynamics may impact outcomes on transobturator male slings.
abstract: OBJECTIVE
  Stress incontinence is frequently seen after prostate surgery. We sought to evaluate preoperative urodynamic (UDS) parameters on functional outcomes after transobturator male sling placement.
  
  
  METHODS
  49 male patients with stress urinary incontinence (SUI) after radical prostatectomy or transurethral resection of the prostate underwent transobturator sling (TOS) placement from December 2008 through June 2011 (AdVance® and Virtue®). A retrospective review was performed of those patients who underwent preoperative UDS and had a minimum of 6 weeks of follow up. In total 38 patients were identified. There were 28 patients considered a success and 10 patients considered a failure. We then evaluated the preoperative UDS parameters between these two groups to identify potential adverse parameters.
  
  
  RESULTS
  Overall success rate was 74% (28/38) with an average follow up of 3 months. Comparing the success and failure groups there was no difference between the pre-operative parameters. On pre-operative UDS, only bladder capacity was found to be significantly lower in those who failed TOS. Univariate comparisons of sling outcomes stratified by bladder capacity tertiles was performed. These values were chosen as they represented the 25th, 50th, and 75th percentiles, respectively. All patients (10/10) with bladder capacities in the top tertile experienced success with the sling, compared to only 62% and 50% of patients in the 50th and 25th tertiles, respectively; these differences were significant (Fisher's exact P-value = 0.044).
  
  
  CONCLUSIONS
  TOS is an effective therapy for men with SUI. Bladder capacity based on pre-operative UDS may impact the success of the procedure.
authors.affiliation: Department of Urology, Mayo Clinic, Phoenix, Arizona, USA. warner.jonathan@mayo.edu
authors.forename: Jonathan N
authors.initials: JN
authors.lastname: Warner
authors.forename: Gwen M
authors.initials: GM
authors.lastname: Grimsby
authors.forename: Mark D
authors.initials: MD
authors.lastname: Tyson
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Wolter
mesh_terms: D000368:Aged; D001130:Arizona; D016009:Chi-Square Distribution; D003950:Diagnostic Techniques, Urological; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D011237:Predictive Value of Tests; D011468:Prostatectomy / Q000009:adverse effects; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D053825:Suburethral Slings; D013997:Time Factors; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000503:physiopathology*; D014550:Urinary Incontinence, Stress / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics; D013521:Urologic Surgical Procedures, Male / Q000009:adverse effects / Q000295:instrumentation*