A prospective study using questionnaires and urodynamic assessments to evaluate bladder function and continence...

Area of Science:

• Urology
• Surgical Oncology
• Pelvic Health

Background:

• Urinary continence and lower urinary tract symptoms are significant concerns for patients following robotic-assisted radical prostatectomy (RaRP).
• Understanding post-operative urinary function is crucial for patient management and quality of life after prostate cancer treatment.

Purpose of the Study:

• To prospectively evaluate subjective urinary symptoms and objective urodynamic parameters before and after RaRP.
• To identify factors influencing immediate continence recovery after robotic prostatectomy.

Main Methods:

• Prospective enrollment of 135 patients undergoing RaRP between January 2019 and August 2020.
• Pre- and post-operative assessments included validated questionnaires (IPSS, UD রোগীদের, OABSS) and pressure-flow studies.
• Follow-up was conducted approximately 3 months post-surgery, with long-term continence assessed up to 1 year.

Main Results:

• Significant increases in storage symptoms were reported at 3 months post-RaRP.
• Over half of patients regained continence within 2 months, but 9.6% remained incontinent at 1 year.
• Urodynamic findings included increased bladder hypersensitivity, decreased detrusor pressure, and reduced bladder contractility and outlet obstruction indices; 11.8% developed de novo detrusor overactivity.

Conclusions:

• RaRP leads to significant changes in lower urinary tract symptoms and urodynamic parameters.
• While continence often recovers, persistent symptoms and de novo overactivity can occur.
• Patient age and bladder neck cross-sectional area are key predictors of immediate post-prostatectomy continence.