Effect of bladder outlet procedures on urodynamic assessments in men with an acontractile or underactive detrusor: A systematic review and meta‐analysis

Objective To review the effect of bladder outlet procedures on urodynamic outcomes and symptom scores in males with detrusor underactivity (DU) or acontractile detrusors (AD). Materials and Methods We performed a systematic review and meta‐analysis of research publications derived from PubMed, Embase, Web of Science, and Ovid Medline to identify clinical studies of adult men with non‐neurogenic DU or AD who underwent any bladder outlet procedure. Outcomes comprised the detrusor pressure at maximum flow (PdetQmax), maximum flow rate (Qmax), international prostate symptom score (IPSS), and quality of life (QoL). This study is registered under PROSPERO CRD42020215832. Results We included 13 studies of bladder outlet procedures, of which 6 reported decreased and 7 reported improved PdetQmax after the procedure. Meta‐analysis revealed an increase in the pooled mean PdetQmax of 5.99 cmH20 after surgery (95% CI: 0.59−11.40; p = 0.03; I2 95%). Notably, the PdetQmax improved in all subgroups with a preoperative bladder contractility index (BCI)