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[Defecation problems following radical perineal prostatectomy. A prospective study].
R Kirschner-Hermanns1, C Knispel, M Möller
1Urologische Klinik, Universitätsklinikum, RWTH, Aachen.
Der Urologe. Ausg. A
|May 17, 2003
Summary
Men undergoing radical prostatectomy frequently experience preoperative bowel issues. Postoperative bowel symptoms like stool smearing are rare, with most patients maintaining good bowel control after surgery.
Area of Science:
- Urology
- Gastroenterology
- Oncology
Context:
- Radical prostatectomy for prostate cancer can impact adjacent structures.
- Preoperative bowel symptoms in these patients are not well-characterized.
- Understanding the incidence of bowel dysfunction is crucial for patient counseling and surgical technique.
Purpose:
- To prospectively evaluate the incidence and nature of bowel symptoms before and after radical perineal prostatectomy.
- To assess the impact of surgery on stool consistency, continence, and defecatory function.
Summary:
- A prospective study evaluated 67 patients undergoing radical perineal prostatectomy using validated questionnaires (Kelly, ICS).
- Preoperatively, 21% reported significant bowel issues, most commonly straining.
- Postoperatively, new-onset stool smearing was rare (13% at 1 year, mostly infrequent), with straining remaining the most frequent symptom.
Impact:
- Highlights that significant preoperative bowel symptoms are common in men undergoing radical prostatectomy.
- Demonstrates that severe postoperative bowel dysfunction, such as daily stool smearing, is uncommon.
- Suggests the importance of preserving the pubo-anal sling and utilizing specific surgical approaches to minimize bowel-related complications.