Should we screen for and treat lower urinary tract dysfunction after major pelvic surgery? ICI-RS 2011

Given the relative frequency of lower urinary tract dysfunction (LUTD) after major pelvic surgery, the main question for this debate is: "Should we [actively] screen for LUTD after major pelvic surgery," with the intention to treat and improve patient care.

The discussants selected relevant papers from a limited review of the literature [PubMed/Medline database (January 1966 to May 2011)] and prepared the YES versus NO presentations.

The evidence was presented for the following major pelvic procedures: colorectal surgery, hysterectomy, and surgery for other benign gynecologic conditions, radical prostatectomy, brachytherapy, and primary cryotherapy for prostate cancer. Based on the presentations, the audience voted in favor of screening for LUTD after major pelvic surgery.

Irreversible treatment should be delayed in case of LUTD after major pelvic surgery. In fact, most symptoms spontaneously subside within 6 months after the surgery. Once the period of 6-12 months of conservative management has been completed and if LUTD persists, a new urodynamic screening should be followed by appropriate treatment.