Radical Prostatectomy May Prevent LUTS Progression

SAN DIEGO—Although radical prostatectomy (RP) frequently has negative effects on quality of life because of urinary incontinence and erectile dysfunction, removal of the prostate can prevent progression of lower urinary tract symptoms (LUTS), according to study findings presented at the American Urological Association annual meeting.

A prospective study of 1,788 men who underwent RP found that men who had clinically significant LUTS preoperatively experienced a decline in LUTS severity and remained stable over a 10-year interval, researchers reported. Prior studies have shown a progressive increase in LUTS for aging men with an intact prostate.

“This is an unrecognized benefit of prostatectomy,” said investigator Vinay Prabhu, a fourth-year medical student at New York University School of Medicine.

The study findings provide evidence that the prostate is the most important contributor to LUTS in men, Prabhu said.

He and his colleagues ascertained subjects' AUA Symptom Index (AUASI) score prior to surgery and at three, six, 12, 24, 48, 60, 84, 96, and 120 months after surgery. The study is the longest reported longitudinal assessment of LUTS after RP, the researchers noted. The prevalence of clinically significant LUTS declined from 35.5% to 26.9% between baseline and 10 years, Prabhu reported. “This is the opposite of what would be expected in the general population,” he said.

The long-term impact of RP on men with baseline clinically significant LUTS who completed the AUASI at baseline and 10 years was a statistically significant decline in mean symptom score from 13.5 to 8.8. “This is a remarkable five-point improvement that remains durable at long-term follow-up,” he said.

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