Document Detail


Bladder and urethral sphincter function after radical retropubic prostatectomy: a prospective long-term study.
MedLine Citation:
PMID:  18006215     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: In a prospective study we analysed the 3-yr results of the effects of radical retropubic prostatectomy (RRP) on detrusor and sphincter function by comparing urodynamic status preoperatively with that during longitudinal follow-up. METHODS: Fifty-four consecutive patients underwent urodynamics with pressure flow studies and Valsalva leak point pressure measurements 3-7 d before RRP (baseline), and then 8 mo after surgery. Thirty-two patients were studied again 3 yr later. We analysed bladder compliance, detrusor overactivity (DO), detrusor contractility, and intrinsic sphincter deficiency (ISD). RESULTS: There was a significant increase in the number of patients with reduced bladder compliance at the 8-mo follow-up. De novo reduced bladder compliance was detected in 32.3% of patients and persisted in 28.1% at the 36-mo follow-up. De novo detrusor hypocontractility was observed in 51% of patients at 8 mo (p<0.05) and persisted in 25% of cases 3 yr later. No patients showed any postvoid residual volume. The associations between detrusor hypocontractility with DO and between detrusor hypocontractility with ISD were detected in 76.2% and 44% of patients, respectively, at 8 mo, and in 25% and in 34% of cases, respectively, at 36 mo of follow-up (p<0.05 and p<0.001). CONCLUSIONS: Following RRP detrusor hypocontractility, decreased bladder compliance, and ISD represent de novo dysfunction probably due to bladder denervation during surgery. They become established conditions over time in about 30% of patients. Nevertheless, they do not produce voiding symptoms because patients develop new voiding behaviours.
Authors:
Antonella Giannantoni; Ettore Mearini; Alessandro Zucchi; Elisabetta Costantini; Luigi Mearini; Vittorio Bini; Massimo Porena
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Publication Detail:
Type:  Journal Article     Date:  2007-11-05
Journal Detail:
Title:  European urology     Volume:  54     ISSN:  0302-2838     ISO Abbreviation:  Eur. Urol.     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-04     Completed Date:  2009-01-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7512719     Medline TA:  Eur Urol     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  657-64     Citation Subset:  IM    
Affiliation:
Department of Urology and Andrology, University of Perugia, Perugia, Italy. agianton@tin.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Chi-Square Distribution
Follow-Up Studies
Humans
Longitudinal Studies
Male
Prospective Studies
Prostatectomy / adverse effects,  methods*
Prostatic Neoplasms / physiopathology*,  surgery*
Statistics, Nonparametric
Treatment Outcome
Urethra / physiopathology*
Urinary Bladder / physiopathology*
Urination Disorders / etiology,  physiopathology
Urodynamics
Comments/Corrections
Comment In:
Eur Urol. 2008 Sep;54(3):664   [PMID:  18006211 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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