Laparoscopic versus open radical prostatectomy: urodynamic evaluation of vesicourethral function

Area of Science:

• Urology
• Surgical Oncology
• Pelvic Floor Function

Background:

• Radical prostatectomy is a standard treatment for localized prostate cancer.
• Assessing the impact of surgical approach on post-operative vesicourethral function is crucial for patient outcomes.

Purpose of the Study:

• To evaluate the effects of laparoscopic radical prostatectomy on vesicourethral function.
• To compare these effects with those of open radical prostatectomy.

Main Methods:

• Retrospective analysis of 63 patients undergoing laparoscopic radical prostatectomy.
• Evaluation of urodynamic parameters: maximum urethral closing pressure (MUCP), functional profile length (FPL), bladder compliance, maximum cystometric capacity (MCC), and detrusor overactivity.
• Comparison of postoperative findings with 58 patients who underwent open radical prostatectomy.

Main Results:

• Laparoscopic radical prostatectomy led to significant postoperative decreases in MUCP and FPL.
• Continence rates were 82% (laparoscopic) and 78% (open).
• Incontinent patients in both groups exhibited lower MUCP, shorter FPL, reduced bladder compliance, and higher detrusor overactivity. Open prostatectomy group showed lower bladder compliance and higher detrusor overactivity.

Conclusions:

• Laparoscopic radical prostatectomy negatively affects bladder storage function and urethral sphincter integrity.
• No significant difference in postoperative urethral function exists between open and laparoscopic radical prostatectomy.
• Laparoscopic surgery may offer a potential advantage in preserving bladder function compared to open surgery.