Presentation Authors: Yuan-Hong Jiang*, Hann-Chorng Kuo, Hualien, Taiwan
Introduction: This study investigated the changes of lower urinary tract function in prostate cancer patients after robotic-assisted radical prostatectomy (RaRP).
Methods: We prospectively enrolled 63 patients who underwent RaRP. Their voiding condition and parameters in videourodynamic studies (VUDS) were investigated before and during the first year after the surgery.
Results: The mean age was 69.9Â±8.2 years old with a mean prostate volume of 36.3Â±17.5 mL. In compared with the preoperative VUDS parameters, increased volume at first sensation of bladder filling (FSF), full sensation (FS), and maximal urinary flow rate, with reduced detrusor voiding pressure and bladder outlet obstruction index were noted at 1 year postoperatively (Table 1). The changes of VUDS parameters including FSF, FS, cystometric bladder capacity, voided volume, and post-void residual urine volume were different between patients with and without preoperative bladder outlet obstruction (BOO). De novo detrusor overactivity (DO) developed in 27.3% of the patients, and the remission rate of DO was 21.4%. At 1 week after the removal, 38.1% of patients were pad-free and continent. Both stress (SUI) and urge (UUI) urinary incontinence rates were gradually reduced at 3 (18.2%, 16.4%), 6 (7.8%, 7.8%), and 12 months (9.5%, 4.8%)(Fig. 1A). After subgroup analysis (Fig. 1), enlarged prostate volume (â‰¥40mL), the presence of preoperative DO, peri-operative neuromuscular bundle scarification, and postoperative radiotherapy had negative impacts on urinary incontinence recovery.
Conclusions: At 1 year after RaRP, patients had significant lower urinary tract function changes. Preoperative BOO affected the changes. SUI and UUI rates gradually improved, with the continence rate more than 90% at 1 year. The key phase of urinary continence recovery was the first 6 months. Preoperative enlarged prostate volume and DO, peri-operative neuromuscular bundle scarification, and post-operative radiotherapy had negative impacts on urinary incontinence recovery.