Changes in Nocturia and Lower Urinary Tract Symptoms after Radical Prostatectomy

Area of Science:

• Urology
• Oncology
• Surgical Innovation

Background:

• Radical prostatectomy, including laparoscopic radical prostatectomy (LRP) and robot-assisted laparoscopic radical prostatectomy (RALP), is a primary treatment for localized prostate cancer.
• Lower urinary tract symptoms (LUTS) are common, and their evolution after prostatectomy requires careful evaluation.

Purpose of the Study:

• To assess changes in nocturia and other LUTS following LRP and RALP.
• To identify factors influencing nocturia after these surgical procedures.

Main Methods:

• Retrospective review of 96 patients undergoing LRP or RALP for prostate cancer.
• Assessment using the International Prostate Symptom Score (IPSS) and evaluation of maximal flow rate and post-void residual urine volume.
• Categorization of patients into groups based on postoperative nocturia changes over a minimum 24-month follow-up.

Main Results:

• Significant improvement in voiding symptoms post-surgery for both LRP and RALP.
• A majority of patients experienced persistent or increased nocturia.
• Over one-third of patients showed exacerbated nocturia (preoperative 1.0±0.9 vs. postoperative 3.0±1.3 episodes).
• Preoperative IPSS storage sub-score negatively correlated with post-prostatectomy nocturia (p=0.005).

Conclusions:

• Nocturia after radical prostatectomy is influenced by storage LUTS and relief of bladder outlet obstruction.
• Preoperative storage symptoms are a key predictor of nocturia changes following radical prostatectomy.