De novo overactive bladder after robot-assisted radical prostatectomy is predicted by a high preoperative overactive bladder symptom score, preoperative dyslipidemia, and non-nerve-sparing surgery.

Objectives: This study investigated whether preoperative patient characteristics and surgery-related factors affect postoperative de novo overactive bladder (OAB) after robot-assisted radical prostatectomy (RARP), and identified three predictive markers.

Methods: Patients without preoperative OAB who underwent RARP at our hospital between February 2013 and October 2020 were included.　At 12 months post-RARP, patients were divided into OAB-free and de novo OAB groups based on the presence of overactive bladder.　Preoperative patient characteristics and surgery-related factors were compared between the two groups.

Results: A total of 404 patients were analyzed (OAB-free group, 338; de novo OAB group, 66).　The preoperative Overactive Bladder Symptom Score (OABSS) and the percentage of patients with dyslipidemia were significantly higher in the de novo OAB group than in the OAB-free group (OABSS, 3.2 ± 1.6 points vs 2.1 ± 1.4, P<0.01; dyslipidemia, 45.5% vs 32.0%, P=0.04).　Nerve-sparing surgery was significantly less common in the de novo OAB group (10.6% vs 27.1%, P<0.01).　Preoperative age, blood pressure, BMI, HbA1c, uroflowmetry parameters, prostate volume, operative time and blood loss showed no significant differences between two groups.

Conclusions: High preoperative OABSS, preoperative dyslipidemia and non-nerve-sparing surgery may be predictive markers for de novo OAB after RARP.