Presented by: David Nusbaum
University of Chicago Medical Center

Introduction

Previous studies have demonstrated that men can identify a motivating or “chief” urinary complaint that drives them to seek treatment. Nocturia has been shown to be the most frequent chief complaint in men with lower urinary tract symptoms (LUTS) presenting to an outpatient urology clinic. However, the distribution of chief complaints and associated characteristics of men undergoing surgery for LUTS secondary to benign prostatic hyperplasia (BPH) are unknown. The objective of this study was to evaluate the distribution of chief complaints and clinical factors in patients electing to undergo a bladder outlet procedure.

Materials

Data were prospectively gathered for consecutive patients who underwent Aquablation between March 2019 and May 2023 at a single institution. All men were asked to identify a chief complaint. Baseline characteristics including prostate size, post-void residual (PVR), and International Prostate Symptom Score (IPSS) were compared, stratified by chief complaint. Change in PVR and IPSS after surgery were assessed. The Kruskal-Wallis test and Fisher’s exact test were used for testing between groups.

Results

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Two-hundred-sixty (260) men who underwent Aquablation for BPH and LUTS were included. Weak stream was the most common chief complaint, reported by 117 (45%) men. Baseline PVR was higher in patients with a chief complaint of weak stream or incomplete emptying, and these men experienced a larger median improvement in PVR after surgery compared to those with other chief complaints. There were no differences in baseline IPSS or change in IPSS after surgery when stratified by chief complaint.

Conclusion

Weak stream was the most common chief complaint in this cohort of men who underwent Aquablation for LUTS and BPH. This differs from the population of men presenting to a urology clinic for LUTS, where nocturia is the most common chief complaint. Men with a chief complaint of weak stream or incomplete emptying had a higher median PVR at baseline, and a larger median improvement in PVR after surgery. Regardless of chief complaint, patients experienced similar improvements in IPSS after surgery.

Funding

None

Co-Authors

Clark Judge,
University of Chicago Medical Center

Hernan Lescay,
University of Chicago Medical Center

Alexander Glaser,
NorthShore University HealthSystem

Brian Helfand,
NorthShore University HealthSystem

James Kearns,
NorthShore University HealthSystem