Urodynamic interpretation of changing bladder function and voiding pattern after radical prostatectomy: a long-term...

Area of Science:

• Urology
• Surgical Oncology
• Pelvic Floor Dysfunction

Background:

• Radical prostatectomy (RP) is a common treatment for prostate cancer.
• Post-surgical changes in bladder function and associated symptoms are significant concerns for patients.

Purpose of the Study:

• To investigate and compare changes in bladder function after radical prostatectomy (RP).
• To correlate changes in subjective voiding symptoms with objective functional changes post-RP.

Main Methods:

• Serial urodynamic studies (UDS) and International Continence Society-male symptom questionnaires were administered to 72 patients before and at 3, 6, and 36 months after RP.
• Changes in bladder contraction and storage function were compared with subjective symptom changes.

Main Results:

• Urodynamic studies revealed reductions in maximum cystometric capacity, detrusor pressure, and maximum urethral closure pressure (MUCP) at 3 months post-RP, with sustained reductions at 3 years.
• Voiding symptom scores improved, but storage symptom scores significantly worsened progressively.
• The incidence of detrusor overactivity increased post-RP, and at 3 years, postvoid residual volume and reduced MUCP correlated with worsened voiding and storage symptoms, respectively.

Conclusions:

• Radical prostatectomy leads to immediate and sustained reductions in bladder capacity, detrusor, and sphincteric activity.
• Despite initial improvements in voiding symptoms, long-term urinary bother is driven by worsening storage symptoms, likely due to sphincteric incompetence and increased detrusor overactivity.