Prognosis of lower urinary tract symptoms and function after robot-assisted radical prostatectomy in patients with preoperative low bladder contractility: A prospective, observational study

Neurourol Urodyn. 2024 Nov;43(8):2240-2248. doi: 10.1002/nau.25577. Epub 2024 Aug 21.

Abstract

Objectives: To examine the prognosis of lower urinary tract symptoms and function after robot-assisted radical prostatectomy (RARP) in patients with low preoperative bladder contractility.

Methods: A total of 115 patients who underwent RARP were enrolled and divided into two groups by preoperative urodynamic findings: normal (patients with bladder contractility index [BCI] ≥ 100; n = 70) and low contractility (patients with BCI < 100; n = 45) groups. Lower urinary tract symptoms and function parameters were prospectively evaluated at 1, 3, 6, 9, and 12 months after RARP in both groups.

Results: International Prostatic Symptom Score voiding scores 1, 3, 6, 9, and 12 months after RARP were significantly higher (p < 0.05), and the maximum flow rate (Qmax) values before and 1, 3, 9, and 12 months after RARP were significantly lower in the low contractility group (p < 0.05). Comparing preoperative and postoperative parameters, IPSS voiding scores in the normal contractility group were significantly improved from 6 months after RARP, whereas those in the low contractility group were almost unchanged. Qmax and the 1-h pad test in both groups temporarily deteriorated 1 month after RARP, whereas voided volume and postvoiding residual volume significantly decreased from 1 to 12 months after RARP.

Conclusions: This observational study showed that patients with low preoperative bladder contractility might have a weak improvement in voiding symptoms and function after RARP.

Keywords: bladder contractility; lower urinary tract function; robot‐assisted radical prostatectomy.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Humans
  • Lower Urinary Tract Symptoms* / diagnosis
  • Lower Urinary Tract Symptoms* / etiology
  • Lower Urinary Tract Symptoms* / physiopathology
  • Lower Urinary Tract Symptoms* / surgery
  • Male
  • Middle Aged
  • Muscle Contraction
  • Prognosis
  • Prospective Studies
  • Prostatectomy* / adverse effects
  • Prostatic Neoplasms / physiopathology
  • Prostatic Neoplasms / surgery
  • Robotic Surgical Procedures* / adverse effects
  • Time Factors
  • Treatment Outcome
  • Urinary Bladder* / physiopathology
  • Urodynamics*