Changes in Urodynamics and Lower Urinary Tract Symptoms after Radical Prostatectomy: Implications of Preoperative Detrusor Contractility

Takahiko Mitsui; Hiroshi Tanaka; Toru Harabayashi; Kimihiko Moriya; Satoru Maruyama; Takashige Abe; Ataru Sazawa; Nobuo Shinohara; Katsuya Nonomura

doi:10.1111/j.1757-5672.2011.00133.x

Changes in Urodynamics and Lower Urinary Tract Symptoms after Radical Prostatectomy: Implications of Preoperative Detrusor Contractility

Low Urin Tract Symptoms. 2012 May;4(2):82-6. doi: 10.1111/j.1757-5672.2011.00133.x. Epub 2012 Jan 30.

Authors

Takahiko Mitsui¹, Hiroshi Tanaka¹, Toru Harabayashi¹, Kimihiko Moriya¹, Satoru Maruyama¹, Takashige Abe¹, Ataru Sazawa¹, Nobuo Shinohara¹, Katsuya Nonomura¹

Affiliation

¹ Department of Urology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan.

PMID: 26676531
DOI: 10.1111/j.1757-5672.2011.00133.x

Abstract

Objectives: Our goal was to identify changes in urodynamic parameters and lower urinary tract symptoms (LUTS) in men followed for1 year after radical prostatectomy (RP) compared to the preoperative measures with a specific focus on detrusor contractility.

Methods: This study enrolled 43 patients who received RP (laparoscopic 27, retropubic: 16) and pressure flow studies (PFS) pre-RP as well as 12 months (M) after RP. No patients complained of urinary incontinence preoperatively. Urodynamic studies and questionnaires regarding LUTS and urinary continence were conducted before and 12 M after RP. Detrusor underactivity (DU) was defined as <10 (W/m(2) ) in preoperative maximum watts factor value.

Results: Urodynamics demonstrated that RP improved urodynamic parameters by releasing bladder outlet obstruction without affecting overall detrusor contractility. Meanwhile, RP did not affect bladder capacity, bladder compliance, or detrusor contractility. LUTS in the International Prostate Symptom Score (IPSS), including the IPSS subscore, was not improved. The quality of life score was significantly better at 12 M after RP and continence rates were gradually improved to be at a satisfactory level in more than 80% of patients by 12 M after RP. DU was preoperatively identified in 21(49%) patients, influencing urodynamic parameters and LUTS preoperatively. However, DU did not affect urodynamic parameters and LUTS after RP.

Conclusion: Although RP improves urodynamic parameters, it does not significantly affect LUTS. Urinary continence gradually improves and is satisfactory within 1 year after RP. The status of preoperative detrusor contractility did not affect urodynamic parameters or LUTS after RP.

Keywords: detrusor underactivity; lower urinary tract symptoms; radical prostatectomy; urinary incontinence; urodynamics.