Comorbid Diabetes Mellitus Contributes to Residual Overactive Bladder After Transurethral Surgery for Benign Prostatic Hyperplasia

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OBJECTIVES: This study aimed to investigate the factors associated with residual overactive bladder after transurethral surgery for benign prostatic hyperplasia. METHODS: This study retrospectively analyzed male patients aged 50 years or older who underwent transurethral surgery for benign prostatic hyperplasia with overactive bladder between January 2014 and December 2022. The subjects were divided into poor and good responder groups based on the presence of overactive bladder after surgery. Preoperative background factors, the International Prostate Symptom Score, Overactive Bladder Symptom Score, free uroflowmetry, pressure flow study, and subjective and objective findings at 3, 6, and 12 months after surgery were compared between the two groups. Furthermore, multivariate analysis was performed to identify risk factors associated with residual overactive bladder after surgery. RESULTS: Sixty-seven patients met the inclusion criteria. Among them, 18 and 49 patients were categorized as poor and good responders, respectively. Compared with the good responders, the poor responders had a significantly higher prevalence of metabolic syndrome, particularly waist circumference ≥ 85 cm and history of diabetes mellitus treatment. In addition, the poor responders had a higher preoperative maximum flow rate and lower bladder outlet obstruction index in the pressure flow study compared with the good responders. Multivariate analysis identified the history of diabetes treatment and the lower bladder outlet obstruction index as predictive factors for residual overactive bladder after surgery for benign prostatic hyperplasia. CONCLUSION: Our findings may improve the prediction of residual overactive bladder after surgery for benign prostatic hyperplasia.

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