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Erschienen in:

09.06.2023 | Original Article

Longitudinal urgency outcomes following robotic-assisted laparoscopic prostatectomy

verfasst von: Emmett H. Kennady, Jacqueline Zillioux, Marwan Ali, Dylan Hutchison, Jacques Farhi, Anthony DeNovio, David Barquin, David E. Rapp

Erschienen in: World Journal of Urology | Ausgabe 7/2023

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Abstract

Purpose

Stress urinary incontinence (SUI) is a well-known adverse outcome following robotic-assisted laparoscopic prostatectomy (RALP). Although postoperative SUI has been extensively studied, little focus has been placed on understanding the natural history and impact of urgency symptoms following RALP. The UVA prostatectomy functional outcomes program (PFOP) was developed to comprehensively assess and optimize continence outcomes following RALP. The present study focuses on assessing urgency outcomes in this cohort.

Methods

PFOP patients with a minimum of 6-months follow up following RALP were included. The PFOP includes prospectively assessed incontinence and quality of life outcomes utilizing ICIQ-MLUTS, Urgency Perception Score (UPS), and IIQ-7 questionnaires. The primary study outcome was urgency urinary incontinence (UUI) as determined by ICIQ-MLUTS UUI domain. Secondary outcomes included urgency (UPS score) and quality of life (IIQ-7).

Results

Forty patients were included with median age 63.5 years. Fourteen (35%) patients reported UUI at baseline. UUI and QOL scores worsened compared to baseline at all time-points. Urgency worsened at 3-weeks and 3-months but returned to baseline by 6-months. Notably, 63% of patients without baseline UUI reported de-novo UUI at 6 months. Although QOL was lower in patients with versus without UUI (IIQ-7 score 3.0 vs 0.0, p = 0.009), severity of UUI was not associated with QOL when controlling for SUI severity.

Conclusion

Our data demonstrate significantly worsened UUI from baseline and a large incidence of de-novo UUI following RALP. Further study is needed to inform how urgency and UUI and its treatment affect health-related quality of life following RALP.

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Bauer RM et al (2011) Contemporary management of postprostatectomy incontinence. Eur Urol 59(6):985–996. https://doi.org/10.1016/j.eururo.2011.03.020CrossRefPubMed

Stanford JL et al. Urinary and sexual function after radical prostatectomy for clinically localized prostate cancer the prostate cancer outcomes study. https://jamanetwork.com/

Hoyland K, Vasdev N (2014) Post–radical prostatectomy incontinence: etiology and prevention. ChM (Urol) 16(4):181–188. https://doi.org/10.3909/riu0606CrossRef

Thiruchelvam N, Cruz F, Kirby M, Tubaro A, Chapple CR, Sievert KD (2015) A review of detrusor overactivity and the overactive bladder after radical prostate cancer treatment. BJU Int 116(6):853–861. https://doi.org/10.1111/bju.13078CrossRefPubMed

Das AK, Kucherov V, Glick L and Chung P (2020) Male urinary incontinence after prostate disease treatment

Agarwal A et al (2014) What is the most bothersome lower urinary tract symptom? Individual- and population-level perspectives for both men and women. Eur Urol 65(6):1211–1217. https://doi.org/10.1016/j.eururo.2014.01.019CrossRefPubMedPubMedCentral

Abrams P, Avery K, Gardener N, Donovan J (2006) The international consultation on incontinence modular questionnaire: www.iciq.net. J Urol 175(3):1063–1066. https://doi.org/10.1016/S0022-5347(05)00348-4CrossRefPubMed

Cardozo L, Coyne KS, Versi E (2005) Validation of the urgency perception scale. BJU Int 95(4):591–596. https://doi.org/10.1111/j.1464-410X.2005.05345.xCrossRefPubMed

Rosen R, Cappelleri J, Smith M, Lipsky J, Peña B (1999) Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 11(6):319–326. https://doi.org/10.1038/sj.ijir.3900472CrossRefPubMed

10.

Shumaker SA, Wyman JF, Uebersax JS, McClish D, Fantl JA (1994) Health-related quality of life measures for women with urinary incontinence: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory. Qual Life Res 3(5):291–306. https://doi.org/10.1007/BF00451721CrossRefPubMed

11.

Hosier GW, Tennankore KK, Himmelman JG, Gajewski J, Cox AR (2016) Overactive bladder and storage lower urinary tract symptoms following radical prostatectomy. Urology 94:193–197. https://doi.org/10.1016/j.urology.2016.05.007CrossRefPubMed

12.

Matsukawa Y et al (2018) De novo overactive bladder after robot-assisted laparoscopic radical prostatectomy. Neurourol Urodyn 37(6):2008–2014. https://doi.org/10.1002/nau.23556CrossRefPubMed

13.

Kan KM, Tin AL, Stearns GL, Eastham JA, Sjoberg DD, Sandhu JS (2022) De novo urinary storage symptoms are common after radical prostatectomy: incidence, natural history and predictors. J Urol 207(3):601–608. https://doi.org/10.1097/JU.0000000000002312CrossRefPubMed

14.

Ventimiglia B, Tsirgiotis A, Panzone I, Coco T, Privitera S (2011) Urinary incontinence after radical prostatectomy. Neurophysiological and urodynamic diagnosis. Urologia Journal 78(2):82–85. https://doi.org/10.5301/RU.2011.7975CrossRefPubMed

15.

Giannantoni A et al (2008) Bladder and urethral sphincter function after radical retropubic prostatectomy: a prospective long-term study. Eur Urol 54(3):657–664. https://doi.org/10.1016/j.eururo.2007.10.054CrossRefPubMed

16.

Leach GE, Trockman B, Wong A, Hamilton J, Haab F, Zimmern PE (1996) Post-prostatectomy incontinence: urodynamic findings and treatment outcomes. J Urol 155(4):1256–1259. https://doi.org/10.1016/S0022-5347(01)66235-9CrossRefPubMed

17.

Jung SY et al (1999) Urethral afferent nerve activity affects the micturition reflex; implication for the relationship between stress incontinence and detrusor instability. J Urol 162(1):204–212. https://doi.org/10.1097/00005392-199907000-00069CrossRefPubMed

18.

Castellani D et al (2022) Change in postoperative storage symptoms and de novo urge incontinence after Thulium: YAG laser enucleation of the prostate: results from a prospective multicenter study. J Endourol. https://doi.org/10.1089/end.2022.0118CrossRefPubMed

19.

Cho MC et al (2011) Predictor of de novo urinary incontinence following holmium laser enucleation of the prostate. Neurourol Urodyn. https://doi.org/10.1002/nau.21050CrossRefPubMed

20.

Coyne KS et al (2009) The burden of lower urinary tract symptoms: evaluating the effect of LUTS on health-related quality of life, anxiety and depression: EpiLUTS

Titel: Longitudinal urgency outcomes following robotic-assisted laparoscopic prostatectomy
verfasst von: Emmett H. Kennady
Jacqueline Zillioux
Marwan Ali
Dylan Hutchison
Jacques Farhi
Anthony DeNovio
David Barquin
David E. Rapp
Publikationsdatum: 09.06.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 7/2023
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-023-04458-0

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Longitudinal urgency outcomes following robotic-assisted laparoscopic prostatectomy