Longitudinal urgency outcomes following robotic-assisted laparoscopic prostatectomy

Area of Science:

• Urology
• Surgical Outcomes
• Quality of Life Research

Background:

• Robotic-assisted laparoscopic prostatectomy (RALP) is associated with stress urinary incontinence (SUI).
• Urgency symptoms following RALP are less understood than SUI.
• The UVA Prostatectomy Functional Outcomes Program (PFOP) was established to evaluate and improve post-RALP continence outcomes.

Purpose of the Study:

• To assess urgency urinary incontinence (UUI) outcomes in patients following RALP.
• To evaluate the natural history and impact of urgency symptoms post-prostatectomy.
• To analyze quality of life changes related to UUI after RALP.

Main Methods:

• Prospective study of 40 patients with at least 6-month follow-up after RALP.
• Utilized ICIQ-MLUTS, Urgency Perception Score (UPS), and IIQ-7 questionnaires.
• Primary outcome: UUI (ICIQ-MLUTS UUI domain). Secondary outcomes: urgency (UPS) and quality of life (IIQ-7).

Main Results:

• UUI and quality of life scores worsened post-RALP compared to baseline.
• 63% of patients without baseline UUI developed de novo UUI at 6 months.
• Lower quality of life was observed in patients with UUI, though severity was not associated with QOL when controlling for SUI.

Conclusions:

• RALP is associated with significantly worsened UUI and a high incidence of de novo UUI.
• Urgency symptoms and UUI require further investigation regarding their impact on health-related quality of life post-RALP.