Men who have preoperative bladder outlet obstruction (BOO) experience significant declines in lower urinary tract (LUT) function 1 year following robotic-assisted radical prostatectomy (RARP) compared with men without BOO, according to study findings presented at the 2019 International Continence Society annual meeting in Gothenburg, Sweden.
Investigators prospectively enrolled 61 men with localized prostate cancer who underwent RARP. The mean age was 69.5 years. Preoperative BOO was present in 37 patients (69.4%). New detrusor overactivity developed 25% of patients; the remission rate of DO was 21.1%.
Patients without preoperative BOO did not experience significant changes in LUT function or bladder outlet dysfunction at 1 year post-RARP. Patients with preoperative BOO, however, had more bladder outlet dysfunction (32%), including intrinsic sphincter deficiency (12%), BOO (12%), detrusor underactivity (4%), and dysfunctional voiding (4%), according to Yuan-Hong Jiang, MD, and colleagues at Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan.
At 1 week following removal of urinary catheters, 37.9% of patients were pad-free and continent. Both stress and urge urinary incontinence rates were gradually reduced by 3 months (22.2% and 15.9%, respectively), 6 months (8.3% and 6.6%), and 12 months (9.8% and 5.9%). The largest degree of urinary continence recovery occurred during the first 6 months postoperatively, the investigators reported.
In subgroup analyses, prostate volume of 40 mL or higher, preoperative BOO, perioperative neuromuscular bundle scarification, and postoperative radiotherapy negatively impacted urinary continence recovery.
Jiang Y, Lee Y, Kuo H. Changes of lower urinary tract function after robotic-assisted radical prostatectomy-A urodynamic follow-up within one year. Presented at the 2019 International Continence Society annual meeting held September 3-6 in Gothenburg, Sweden. Abstract 1.