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[Consecutive evaluation of vesico-urethral function in patients undergoing radical retropubic prostatectomy]
M Ando1, H Nagamatsu, T Morita
1Department of Urology, Tokyo Medical and Dental University, Faculty of Medicine.
Summary
Radical retropubic prostatectomy significantly impacts bladder function and urethral pressure, leading to temporary incontinence. However, most patients regain bladder control within 12 months, though urethral function remains impaired.
Area of Science:
- Urology
- Surgical Oncology
- Pelvic Floor Function
Context:
- Radical retropubic prostatectomy (RRP) is a standard treatment for prostate cancer.
- Postoperative vesico-urethral dysfunction, including urinary incontinence, is a common complication.
- Understanding the functional changes after RRP is crucial for patient management.
Purpose:
- To evaluate vesico-urethral function following radical retropubic prostatectomy using urodynamic studies.
- To assess the impact of RRP on bladder compliance, urethral closure pressure, and incontinence over 12 months.
- To identify risk factors for persistent postoperative urinary incontinence.
Summary:
- Urodynamic studies in 18 male patients showed low bladder compliance and reduced urethral closure pressure (UCPmax) and functional profile length (FPL) post-RRP.
- While bladder compliance normalized by 12 months, reduced FPL and UCPmax persisted.
- Urinary incontinence improved significantly, with 61% achieving complete control, but 33% experienced stress incontinence.
Impact:
- Shortened FPL is a significant risk factor for postoperative urinary incontinence after RRP.
- Neurovascular bundle resection and lower UCPmax may influence incontinence.
- Early postoperative low bladder compliance is also implicated in incontinence.