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Current Bladder Dysfunction Reports
Published in: Current Bladder Dysfunction Reports 3/2019

01-09-2019 | Overactive Bladder | Overactive Bladder (U Lee and S Adelstein, Section Editors)

Management of Overactive Bladder After Treatment of Bladder Outlet Obstruction

Authors: Jeffrey L. Ellis, Avery E. Braun, Joshua A. Cohn

Published in: Current Bladder Dysfunction Reports | Issue 3/2019

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Abstract

Purpose of Review

To discuss the epidemiology and pathophysiology of overactive bladder (OAB) after bladder outlet surgery (BOS), review the prognostic factors associated with persistent OAB, and present evaluation and management strategies.

Recent Findings

A randomized trial of preoperative urodynamics in male lower urinary tract symptoms is underway; however, high-level evidence for management of persistent OAB after BOS is lacking.

Summary

Identification of prognostic factors for persistent OAB symptoms is important for counseling patients before BOS; however, the data guiding such counseling are limited. In general, patients who are older, have lower bladder capacity, and higher amplitude and earlier detrusor overactivity are more likely to have persistent symptoms. After BOS, men may be less likely than women to respond favorably to advanced therapies for OAB than women and should be appropriately counseled.
Literature
1.
•• Antunes AA, Iscaife A, Reis ST, Albertini A, Nunes MA, Lucon AM, et al. Can we predict which patients will experience resolution of detrusor overactivity after transurethral resection of the prostate? J Urol. 2015;193(6):2028–32 This paper comprehensively addresses preoperative and predictive factors including urodynamic and uroflow findings and how these may affect outcomes specifically regarding OAB symptoms post-operatively. CrossRef
2.
Parsons JK. Benign prostatic hyperplasia and male lower urinary tract symptoms: epidemiology and risk factors. Curr Bladder Dysfunct Rep. 2010;5(4):212–8.CrossRef
3.
Meier K, Padmanabhan P. Female bladder outlet obstruction: an update on diagnosis and management. Curr Opin Urol. 2016;26(4):334–41.CrossRef
4.
Lamin E, Strother MC, Smith AL. The evidence for female pelvic medicine interventions. Curr Bladder Dysfunct Rep. 2017;12(1):8–14.CrossRef
5.
Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An International Urogynecological Association (IUGA)/ International ContinenceSociety (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29(1):4–20.PubMed
6.
Chapple CR, Drake MJ, Van Kerrebroeck P, Cardozo L, Drogendijk T, Klaver M, et al. Total urgency and frequency score as a measure of urgency and frequency in overactive bladder and storage lower urinary tract symptoms. BJU Int. 2014;113(5):696–703.CrossRef
7.
Abrams P, Cardozo L, Wagg A, Wein A, editors. Incontinence 6th edition. 6th ed. Bristol: ICI-ICS. International Continence Society; 2017.
8.
Coyne KS, Sexton CC, Thompson CL, Milsom I, Irwin D, Kopp ZS, et al. The prevalence of lower urinary tract symptoms (LUTS) in the USA, the UK and Sweden: results from the epidemiology of LUTS (EpiLUTS) study. BJU Int. 2009;104(3):352–60.CrossRef
9.
Lee C-L, Kuo H-C. Pathophysiology of benign prostate enlargement and lower urinary tract symptoms: current concepts. Tzu Chi Med J. 2017;29(2):79–83.
10.
• Johnson JR, High RA, Dziadek O, Ocon A, Muir TW, Xu J, et al. Overactive bladder symptoms after pelvic organ prolapse. Female Pelvic Med Reconstr Surg. 2019;1–4. This single-institution retrospective study identified risk factors for persistent OAB symptoms as well as de novo OAB after POP surgery.
11.
Tomoe H, Clinical Investigation. Improvement of overactive bladder symptoms after tension-free vaginal mesh operation in women with pelvic organ prolapse : correlation with preoperative urodynamic findings. Int J Urol. 2015;22(6):577–80.CrossRef
12.
Keay SK, Birder LA, Chai TC. Evidence for bladder urothelial pathophysiology in functional bladder disorders. Biomed Res Int. 2014;2014:1–16.CrossRef
13.
BRADING AF, TURNER WH. The unstable bladder: towards a common mechanism. Br J Urol. 1994;73(1):3–8.CrossRef
14.
Brading AF. A myogenic basis for the overactive bladder. Urology. 1997;50(Supplement 6A):57–67.CrossRef
15.
Zhao Z, Azad R, Yang J-H, Siroky MB, Azadzoi KM. Progressive changes in derusor function and micturition patterns with chronic bladder ischemia. Investig Clin Urol. 2016;57(4):249–59.CrossRef
16.
Parsons BA, Drake MJ. Animal models in overactive bladder research. In: Handbook of experimental pharmacology: urinary tract; 2011. p. 15–43.CrossRef
17.
Barbosa JABA, Reis ST, Nunes M, Ferreira YA, Leite KR, Nahas WC, et al. The obstructed bladder: expression of collagen, matrix metalloproteinases, muscarinic receptors, and angiogenic and neurotrophic factors in patients with benign prostatic hyperplasia. Urology. 2017;106:167–72.CrossRef
18.
Mitterberger M, Pallwein L, Gradl J, Frauscher F, Neuwirt H, Leunhartsberger N, et al. Persistent detrusor overactivity after transurethral resection of the prostate is associated with reduced perfusion of the urinary bladder. 2006;831–5.
19.
Andersson KE, Boedtkjer DB, Forman A. The link between vascular dysfunction, bladder ischemia, and aging bladder dysfunction. Ther Adv Urol. 2017;9(1):11–27.CrossRef
20.
Holm N, Horn T. Detrusor in ageing and obstruction. Scand J Urol Nephrol. 1995;29(1):45–9.CrossRef
21.
• Housami F, Abrams P. Persistent detrusor overactivity after transurethral resection of the prostate. Curr Urol Rep. 2008;9(4):284–90 This paper provides insight into how to manage male patients who experience continued OAB after BOO procedure. CrossRef
22.
Knutson T, Edlund C, Fall M, Dahlstrand C. BPH with coexisting overactive bladder dysfunction - an everyday urological dilemma. Neurourol Urodyn. 2001;20(3):237–47.CrossRef
23.
•• Choi H, Kim JH, Shim JS, Park JY, Kang SH, Moon DG, et al. Prediction of persistent storage symptoms after transurethral resection of the prostate in patients with benign prostatic enlargement. Urol Int. 2014;93(4):425–30 This is a well-written, comprehensive retrospective study looking at predictive factors impacting persistent detrusor overactivity in those who have already undergone surgical intervention for bladder outlet procedure. CrossRef
24.
De Nunzio C, Franco G, Rocchegiani A, Iori F, Leonardo C, Laurenti C. The evolution of detrusor overactivity after watchful waiting, medical therapy and surgery in patients with bladder outlet obstruction. J Urol. 2003;169(February):535–9.CrossRef
25.
Long CY, Hsu CS, Wu MP, Liu CM, Chiang PH, Juan YS, et al. Predictors of improved overactive bladder symptoms after transvaginal mesh repair for the treatment of pelvic organ prolapse: predictors of improved OAB after POP repair. Int Urogynecol J. 2011;22(5):535–42.CrossRef
26.
De Boer TA, Vierhout ME. Predictors for overactive bladder symptoms after pelvic organ prolapse surgery. Curr Opin Obstet Gynecol. 2011;23(5):366–70.PubMed
27.
Kim MS, Lee GH, Na ED, Jang JH, Kim HC. The association of pelvic organ prolapse severity and improvement in overactive bladder symptoms after surgery for pelvic organ prolapse. Obstet Gynecol Sci. 2016;59(3):214–9.CrossRef
28.
Kim TI, Song JM, Chung HC. Analysis of the factors causing bladder irritation after transurethral resection of the prostate. Korean J Urol. 2010;51(10):700–3.CrossRef
29.
Hur WS, Kim JC, Kim HS, Koh JS, Kim SH, Kim HW, et al. Predictors of urgency improvement after holmium laser enucleation of the prostate in men with benign prostatic hyperplasia. Investig Clin Urol. 2016;57(6):431–6.CrossRef
30.
Wada N, Watanabe M, Kita M, Matsumoto S, Kakizaki H. Analysis of bladder vascular resistance before and after prostatic surgery in patients with lower urinary tract symptoms suggestive of benign prostatic obstruction. Neurourol Urodyn. 2012;31(5):659–63.CrossRef
31.
Cho MC, Kim HS, Lee CJ, Ku JH, Kim SW, Paick JS. Influence of detrusor overactivity on storage symptoms following potassium-titanyl-phosphate photoselective vaporization of the prostate. Urology. 2010;75(6):1460–6.CrossRef
32.
Guzman-Negron J, Vasavada S. Management of overactive bladder in the face of high grade prolapse. Curr Urol Rep. 2017;18(2):2–6.CrossRef
33.
Miranne JM, Lopes V, Carberry CL, Sung VW. The effect of pelvic organ prolapse severity on improvement in overactive bladder symptoms after pelvic reconstructive surgery. Int Urogynecol J. 2013;24(8):1303–8.CrossRef
34.
Lewis AL, Young GJ, Abrams P, Blair PS, Chapple C, Glazener CMA, et al. Clinical and patient-reported outcome measures in men referred for consideration of surgery to treat lower urinary tract symptoms : baseline results and diagnostic findings of the urodynamics for prostate surgery trial ; randomised evaluation of assessmen. Eur Urol Focus 2019;1–11.
35.
Jiang YH, Wang CC, Kuo HC. Videourodynamic findings of lower urinary tract dysfunctions in men with persistent storage lower urinary tract symptoms after medical treatment. PLoS One. 2018;13(2):1–10.
36.
•• Zhao YR, Liu IZ, Guralnick M, Niu WJ, Wang Y, Sun G, et al. Predictors of short-term overactive bladder symptom improvement after transurethral resection of prostate in men with benign prostatic obstruction. Int J Urol. 2014;21(10):1035–40 This paper provides a systematic review of evidence regarding factors impacting outcomes of transurethral surgery in men with preoperative OAB symptoms. CrossRef
37.
Saito K, Hisasue SI, Ide H, Aoki H, Muto S, Yamaguchi R, et al. The impact of increased bladder blood flow on storage symptoms after holmium laser enucleation of the prostate. PLoS One. 2015;10(6):1–8.
38.
Wilson LC, Gilling PJ, Williams A, Kennett KM, Frampton CM, Westenberg AM, et al. A randomised trial comparing holmium laser enucleation versus transurethral resection in the treatment of prostates larger than 40 grams: results at 2 years. Eur Urol. 2006;50(3):569–73.CrossRef
39.
Kaplan SA, Walmsley K, Te AE. Tolterodine extended release attenuates lower urinary tract symptoms in men with benign prostatic hyperplasia. J Urol. 2005;174(6):2273–6.CrossRef
40.
Dmochowski R, Abrams P, Marschall-Kehrel D, Wang JT, Guan Z. Efficacy and tolerability of tolterodine extended release in male and female patients with overactive bladder. Eur Urol. 2007;51(4):1054–64.CrossRef
41.
Höfner K, Burkart M, Jacob G, Jonas U. Safety and efficacy of tolterodine extended release in men with overactive bladder symptoms and presumed non-obstructive benign prostatic hyperplasia. World J Urol. 2007;25(6):627–33.CrossRef
42.
Sebastianelli A, Russo GI, Kaplan SA, McVary KT, Moncada I, Gravas S, et al. Systematic review and meta-analysis on the efficacy and tolerability of mirabegron for the treatment of storage lower urinary tract symptoms/overactive bladder: comparison with placebo and tolterodine. Int J Urol. 2018;25(3):196–205.CrossRef
43.
Ichihara K, Masumori N, Fukuta F, Tsukamoto T, Iwasawa A, Tanaka Y. A randomized controlled study of the efficacy of tamsulosin monotherapy and its combination with mirabegron for overactive bladder induced by benign prostatic obstruction. J Urol. 2015;193(3):921–6.CrossRef
44.
Kosilov KV, Loparev SA, Ivanovskaya MA, Kosilova LV. Comparative effectiveness of combined low- and standard-dose trospium and solifenacin for moderate overactive bladder symptoms in elderly men and women. Urol Int. 2014;93(4):470–3.CrossRef
45.
Kosilov K, Loparev S, Ivanovskaya M, Kosilova L. Additional correction of OAB symptoms by two anti-muscarinics for men over 50 years old with residual symptoms of moderate prostatic obstruction after treatment with tamsulosin. Aging Male. 2015;18(1):44–8.CrossRef
46.
Van Kerrebroeck P, Chapple C, Drogendijk T, Klaver M, Sokol R, Speakman M, et al. Combination therapy with solifenacin and tamsulosin oral controlled absorption system in a single tablet for lower urinary tract symptoms in men: efficacy and safety results from the randomised controlled NEPTUNE trial. Eur Urol. 2013;64(6):1003–12.CrossRef
47.
Sahai A, Dowson C, Khan MS, Dasgupta P. Improvement in quality of life after botulinum toxin - a injections for idiopathic detrusor overactivity: results from a randomized double-blind placebo-controlled trial. BJU Int. 2009;103(11):1509–15.CrossRef
48.
Dmochowski R, Chapple C, Nitti VW, Chancellor M, Everaert K, Thompson C, et al. Efficacy and safety of onabotulinumtoxina for idiopathic overactive bladder: a double-blind, placebo controlled, randomized, dose ranging trial. J Urol. 2010;184(6):2416–22.CrossRef
49.
Irwin P, Craciun M. Outcomes for intravesical abobotulinumtoxin A (Dysport®) treatment in the active management of overactive bladder symptoms – a prospective study. Urology. 2019;1–5.
50.
Kuo HC, Liao CH, Chung SD. Adverse events of intravesical botulinum toxin a injections for idiopathic detrusor overactivity: risk factors and influence on treatment outcome. Eur Urol. 2010;58(6):919–26.CrossRef
51.
Habashy D, Losco G, Tse V, Collins R, Chan L. Botulinum toxin (onabotulinumtoxinA) in the male non-neurogenic overactive bladder: clinical and quality of life outcomes. BJU Int. 2015;116(Supplement 3):61–5.CrossRef
52.
Burton C, Sajja A, Latthe PM. Effectiveness of percutaneous posterior tibial nerve stimulation for overactive bladder: a systematic review and meta-analysis. Neurourol Urodyn. 2012;31(8):1206–16.CrossRef
53.
Davis T, Makovey I, Guralnick ML, O’Connor RC. Sacral neuromodulation outcomes for the treatment of refractory idiopathic detrusor overactivity stratified by indication: lack of anticholinergic efficacy versus intolerability. J Can Urol Assoc. 2013;7(5–6 JUN):176–8.CrossRef
54.
Goldman HB, Lloyd JC, Noblett KL, Carey MP, Castaño Botero JC, Gajewski JB, et al. International continence society best practice statement for use of sacral neuromodulation. Neurourol Urodyn. 2018;37(5):1823–48.CrossRef
55.
Van Balken MR, Vergunst H, Bemelmans BLH. Prognostic factors for successful percutaneous tibial nerve stimulation. Eur Urol. 2006;49(2):360–5.CrossRef
56.
Stensland KD, Sluis B, Vance J, Schober JP, MacLachlan LS, Mourtzinos AP. Predictors of nerve stimulator success in patients with overactive bladder. Int Neurourol J. 2018;22(3):206–11.CrossRef
57.
Adelstein SA, Lee W, Gioia K, Moskowitz D, Stamnes K, Lucioni A, et al. Outcomes in a contemporary cohort undergoing sacral neuromodulation using optimized lead placement technique. Neurourol Urodyn 2019;(April):1–7.
58.
Bartley JM, Ramirez V, Killinger KA, Boura JA, Gupta P, Gaines N, et al. Outcomes of sacral neuromodulation in patients with prior surgical treatments of stress urinary incontinence and pelvic organ prolapse. Female Pelvic Med Reconstr Surg. 2017;23(1):8–12.CrossRef
59.
Nguyen LN, Bartley J, Killinger KA, Gupta P, Lavin J, Khourdaji A, et al. Does sex matter? A matched pairs analysis of neuromodulation outcomes in women and men. Int Urol Nephrol. 2018;50(5):825–32.CrossRef
Metadata
Title
Management of Overactive Bladder After Treatment of Bladder Outlet Obstruction
Authors
Jeffrey L. Ellis
Avery E. Braun
Joshua A. Cohn
Publication date
01-09-2019
Publisher
Springer US
Published in
Current Bladder Dysfunction Reports / Issue 3/2019
Print ISSN: 1931-7212
Electronic ISSN: 1931-7220
DOI
https://doi.org/10.1007/s11884-019-00527-6

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