MP74-19: The preoperative dyslipidemia and high overactive bladder symptom score predict de novo overactive bladder after robot-assisted radical prostatectomy
Department of Urology, Fukushima Medical University
Introduction: Some patients have de novo overactive bladder (de novo OAB) after robot-assisted radical prostatectomy (RARP). It is possible that the preoperative characteristics of the patient contribute to onset of de novo OAB after RARP. The aim of this study is to determine whether the preoperative characteristics of the patients affect the de novo OAB after RARP. Methods: Patients without OAB who underwent RARP for localized prostate cancer at our hospital between February 2013 and October 2020 were included in this study. At 12 months after RARP, these patients were divided into the OAB-free group and de novo OAB group according to absence or presence of OAB. The preoperative age, blood pressure, obesity (BMI = 25 kg/m2), dyslipidemia (LDL-C/HDL-C ratio = 2.5), HbA1c, uroflowmetry parameter, prostate volume (PV) and overactive bladder symptom score (OABSS) were compared between the OAB-free group and de novo OAB group. Results: A total of 404 patients (67.0 ± 5.3 years) entered the study (OAB-free group: 338 patients, de novo OAB group: 66 patients). The percentage of patients with dyslipidemia was significantly higher in the de novo OAB group than in the OAB-free group (OAB-free group vs de novo OAB group: 32.0 % vs 45.5 %, P=0.04). The total OABSS was significantly higher in the de novo OAB group than in the OAB-free group (OAB-free group vs de novo OAB group: 2.1 ± 1.4 points vs 3.2 ± 1.6 points, P<0.01). The other preoperative characteristics of the patients were not significant differences between two groups. Conclusions: We demonstrated that preoperative dyslipidemia, which was defined as LDL-C/HDL-C ratio = 2.5 in this study, and high OABSS contributed to de novo OAB after RARP. Recent studies have demonstrated that dyslipidemia contributes to the lower urinary tract dysfunction. Several studies have also reported that elevated LDL-C/HDL-C ratio is associated with progression of atherosclerosis1). The atherosclerosis is well known to cause OAB by chronic bladder ischemia. The preoperative elevated LDL-C/HDL-C ratio may cause de novo OAB after RARP through chronic bladder ischemia. The patients with preoperative high OABSS might have bladder instability although they were not diagnosed as OAB. The bladder instability might become worse after RARP, resulting in de novo OAB. The preoperative dyslipidemia and high OABSS may be useful marker of de novo OAB after RARP. SOURCE OF Funding: 1) Noike H, et al: Relationships between intravascular ultrasonographic findings and coronary risk factors in patients with normal coronary angiography. J Cardiol. 2005;45:1-10.
