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Effect of preoperative urodynamic detrusor overactivity on post-prostatectomy incontinence: a systematic review and meta-analysis

  • Urology - Original Paper
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Abstract

Purpose

To investigate whether preoperative urodynamic detrusor overactivity (DO) contributes to post-prostatectomy incontinence (PPI).

Methods

We systematically searched the online PubMed, Embase, and Cochrane Library databases spanning the period of January 1989 to December 2014.

Results

A total of nine articles met the eligibility criteria for this systematic review. The eligible studies included a total of 457 patients with a median number of 58 patients per study (range 17–92). Of the nine studies, five conducted open retropubic radical prostatectomy (RRP), two performed robot-assisted laparoscopic prostatectomy (RALP), and two others utilized multiple modalities. PPI was more likely to occur in patients with preoperative DO [pooled odds ratio (OR) 2.30; 95 % confidence interval (CI) 1.39–3.82; studies 9; participants 419], as compared to patients who were DO negative. Sensitivity analysis using the subgroups of RRP (OR 2.32; 95 % CI 1.11–4.85), RALP (OR 3.41; 95 % CI 1.55–7.47), DO defined as any amplitude of involuntary contraction (OR 2.32; 95 % CI 1.11–4.85), no postoperative intervention (OR 2.32; 95 % CI 1.11–4.85), and outcome evaluation after 6 months (OR 2.32; 95 % CI 1.11–4.85) demonstrated consistent results. Although some comparisons showed inter-study heterogeneity, there was no clear evidence of publication bias in this meta-analysis.

Conclusions

Our meta-analysis results suggest that preoperative DO is another possible underlying mechanism for PPI.

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Acknowledgments

The authors are indebted to Jung-Yun Lee (E-mail: yodrum682@gmail.com), Clinical Fellow, Department of Obstetrics and Gynecology, Seoul National University Hospital, for his pro bono technical advice for meta-analysis. The authors are also indebted to Sebin Jeong, Clinical Fellow, Department of Urology, Asan Medical Center, for his pro bono editing of this manuscript.

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Authors and Affiliations

  1. Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, South Korea

    Myong Kim, Myungchan Park, Myungsun Shim, Seung-Kwon Choi, Sang Mi Lee, Cheryn Song, Myung-Soo Choo & Hanjong Ahn

  2. Department of Urology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea

    Eun-Sik Lee

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  1. Myong Kim
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Correspondence to Hanjong Ahn.

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This article does not contain any studies involving human or animal subjects performed by any of the authors.

Appendices

Appendix 1

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Table 4 Detailed query settings for search strategy
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Appendix 2

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Table 5 Related matters regarding processing the outcome parameters for data synthesis
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Kim, M., Park, M., Shim, M. et al. Effect of preoperative urodynamic detrusor overactivity on post-prostatectomy incontinence: a systematic review and meta-analysis. Int Urol Nephrol 48, 53–63 (2016). https://doi.org/10.1007/s11255-015-1141-7

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  • DOI: https://doi.org/10.1007/s11255-015-1141-7

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