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Association Between Intraoperative Prostate Bed Blood Flow and Postoperative Lower Urinary Tract Symptoms After
Chikao Aoyagi1, Shintaro Aso1, Masahiro Tachibana1
1Department of Urology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
The Prostate
|July 2, 2026
Summary
Preserving prostate bed blood flow during robot-assisted radical prostatectomy (RARP) significantly reduces postoperative lower urinary tract symptoms (LUTS). Nerve-sparing techniques are key to maintaining this vital blood flow after RARP.
Area of Science:
- Urology
- Surgical Oncology
- Andrology
Background:
- Pelvic ischemia is linked to lower urinary tract dysfunction.
- The effect of intraoperative prostate bed blood flow on postoperative lower urinary tract symptoms (LUTS) after robot-assisted radical prostatectomy (RARP) is not well understood.
Purpose of the Study:
- To investigate the association between intraoperative prostate bed blood flow and LUTS following RARP.
Main Methods:
- A prospective cohort study of 52 patients undergoing RARP.
- Prostate bed blood flow was measured intraoperatively using a laser Doppler flowmeter.
- Patients were categorized into preserved-flow and reduced-flow groups based on perioperative blood flow changes. Postoperative LUTS and function were assessed at 1 month.
Main Results:
- The preserved-flow group exhibited significantly lower International Prostate Symptom Score (IPSS) and Overactive Bladder Symptom Score (OABSS) at 1 month post-surgery.
- Nerve-sparing status was identified as an independent predictor of preserved postoperative blood flow.
Conclusions:
- Maintaining prostate bed blood flow during RARP is associated with improved postoperative LUTS.
- Nerve-sparing status is an independent factor linked to better postoperative prostate bed blood flow.
