Changes in Bladder Outlet Obstruction After Photoselective Vaporization of the Prostate in Men With and Without Detrusor Underactivity: A Retrospective Propensity Score-Matched Study

IF 1.8 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms Pub Date : 2026-10-09 DOI:10.1111/luts.70100

Jurai Shibuya, Yuki Kyoda, Kohei Hashimoto, Ko Kobayashi, Toshiaki Tanaka, Naoya Masumori

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引用次数: 0

Abstract

Objectives

To compare symptomatic improvement after photoselective vaporization of the prostate (PVP) between patients with and without detrusor underactivity (DU), together with objective changes in urodynamic parameters assessed by pressure-flow study (PFS).

Methods

This single-center retrospective study evaluated 136 benign prostatic hyperplasia (BPH) patients treated with a 180 W PVP-XPS system from 2020 through 2025. The patients were divided into DU and non-DU groups based on the bladder contractility index (BCI), with DU defined as BCI < 100. We retrospectively analyzed selected patients with BPH and clinically or urodynamically relevant bladder outlet obstruction (BOO) who underwent PVP and completed PFS before and 6 months after surgery. Propensity score matching (PSM) was applied to adjust for age and the baseline BOO index (BOOI).

Results

A total of 105 patients were included in the final analysis and 53 were in the DU group. The DU group had a significantly lower BOOI (48.6 ± 17.5 vs. 71.4 ± 32.3, p < 0.01) than the non-DU group. After PSM, age and baseline BOOI were well balanced, but BCI remained significantly different. No significant differences between the two groups were observed in questionnaire scores or uroflowmetry findings at 6 months after surgery. The BOOI at 6 months after surgery was not significantly different between the DU group (13.4 ± 13.7) and the non-DU group (13.7 ± 19.3) (p = 0.93). BOOI reduction was also not significantly different between the DU group (−37.0 ± 24.1) and the non-DU group (−36.2 ± 24.5) (p = 0.90).

Conclusion

In selected patients with clinically or urodynamically relevant BOO, significant improvements in BOOI and LUTS were observed in patients with DU after PVP, with no statistically significant between-group differences detected at 6 months.

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有或无逼尿肌活动不足的男性在前列腺光选择性汽化后膀胱出口梗阻的变化：回顾性倾向评分匹配研究

目的比较光选择性前列腺汽化术（PVP）后逼尿肌功能不全（DU）患者和非DU患者的症状改善情况，以及压力流研究（PFS）评估的尿动力学参数的客观变化。方法本单中心回顾性研究评估了2020年至2025年期间使用180w PVP-XPS系统治疗的136例良性前列腺增生（BPH）患者。根据膀胱收缩指数（BCI）将患者分为DU组和非DU组，定义DU为BCI 100。我们回顾性分析了选择的BPH和临床或尿动力学相关的膀胱出口梗阻（BOO）患者，他们在术前和术后6个月接受了PVP并完成了PFS。采用倾向评分匹配（PSM）来调整年龄和基线BOO指数（BOOI）。结果105例患者纳入最终分析，其中DU组53例。DU组BOOI（48.6±17.5∶71.4±32.3,p < 0.01）明显低于非DU组。PSM后，年龄和基线BOOI平衡良好，但BCI仍有显著差异。两组术后6个月的问卷评分和尿流测量结果无显著差异。术后6个月，DU组BOOI（13.4±13.7）与非DU组（13.7±19.3）差异无统计学意义（p = 0.93）。DU组（- 37.0±24.1）与非DU组（- 36.2±24.5）之间的BOOI降低也无显著差异（p = 0.90）。结论在选定的与临床或尿动力学相关的BOO患者中，PVP后DU患者的BOOI和LUTS均有显著改善，6个月时组间差异无统计学意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

LUTS: Lower Urinary Tract Symptoms UROLOGY & NEPHROLOGY-

CiteScore

3.00

自引率

7.70%

发文量

审稿时长

>12 weeks

期刊介绍： LUTS is designed for the timely communication of peer-reviewed studies which provides new clinical and basic science information to physicians and researchers in the field of neurourology, urodynamics and urogynecology. Contributions are reviewed and selected by a group of distinguished referees from around the world, some of whom constitute the journal''s Editorial Board. The journal covers both basic and clinical research on lower urinary tract dysfunctions (LUTD), such as overactive bladder (OAB), detrusor underactivity, benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO), urinary incontinence, pelvic organ prolapse (POP), painful bladder syndrome (PBS), as well as on other relevant conditions. Case reports are published only if new findings are provided. LUTS is an official journal of the Japanese Continence Society, the Korean Continence Society, and the Taiwanese Continence Society. Submission of papers from all countries are welcome. LUTS has been accepted into Science Citation Index Expanded (SCIE) with a 2011 Impact Factor.