TY - JOUR
T1 - Role of Bladder Functional Testing Prior to Surgeries for Benign Prostatic Obstruction
AU - Mazeaud, Charles
AU - Hernandez, Natalia
AU - Gonzalez, Ricardo R.
N1 - © 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2023/8
Y1 - 2023/8
N2 - PURPOSE OF REVIEW: There is no consensus on preoperative functional testing prior to surgeries for benign prostatic obstruction causing lower urinary tract symptoms (LUTS).RECENT FINDINGS: Surgical management offers definite benefits, but the results are not always satisfactory. The urodynamic study (UDS) is the gold standard for assessing bladder outlet obstruction (BOO) which is the best predictor of surgical success. Yet, it is not recommended by our urologic societies as standard testing prior to surgery. In this narrative review of the literature, we report recent findings and controversies regarding the benefits and downside of UDS, and the use of other less-invasive approaches to achieve this goal. The lack of strong evidence for or against performing UDS was surprising. Prospective UDS data may not predict surgical outcomes if there is no consensus on criteria that directs surgical intervention. However, confirming the presence of BOO and characterizing the bladder function to identify detrusor over- and underactivity may help counselling and setting patient's post-operative expectations. Urocuff, a non-invasive testing offers promising results to address this problem with a less-invasive assessment of BOO. We emphasize better pre-operative characterization of patients to confirm BOO and better define subgroups to improve surgical decision-making.
AB - PURPOSE OF REVIEW: There is no consensus on preoperative functional testing prior to surgeries for benign prostatic obstruction causing lower urinary tract symptoms (LUTS).RECENT FINDINGS: Surgical management offers definite benefits, but the results are not always satisfactory. The urodynamic study (UDS) is the gold standard for assessing bladder outlet obstruction (BOO) which is the best predictor of surgical success. Yet, it is not recommended by our urologic societies as standard testing prior to surgery. In this narrative review of the literature, we report recent findings and controversies regarding the benefits and downside of UDS, and the use of other less-invasive approaches to achieve this goal. The lack of strong evidence for or against performing UDS was surprising. Prospective UDS data may not predict surgical outcomes if there is no consensus on criteria that directs surgical intervention. However, confirming the presence of BOO and characterizing the bladder function to identify detrusor over- and underactivity may help counselling and setting patient's post-operative expectations. Urocuff, a non-invasive testing offers promising results to address this problem with a less-invasive assessment of BOO. We emphasize better pre-operative characterization of patients to confirm BOO and better define subgroups to improve surgical decision-making.
KW - Benign prostate obstruction
KW - Bladder outlet obstruction
KW - Cuff
KW - Lower urinary tract
KW - Urodynamics
KW - Lower Urinary Tract Symptoms/diagnosis
KW - Prospective Studies
KW - Humans
KW - Male
KW - Prostatic Hyperplasia/complications
KW - Urinary Bladder Neck Obstruction/diagnosis
KW - Urethral Obstruction/complications
KW - Urinary Bladder/surgery
UR - http://www.scopus.com/inward/record.url?scp=85161359724&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85161359724&partnerID=8YFLogxK
U2 - 10.1007/s11934-023-01165-6
DO - 10.1007/s11934-023-01165-6
M3 - Review article
C2 - 37289378
AN - SCOPUS:85161359724
SN - 1527-2737
VL - 24
SP - 401
EP - 407
JO - Current Urology Reports
JF - Current Urology Reports
IS - 8
ER -