Presentation Authors: Jun Nyung Lee, Kyeong-Hyeon Byeon*, Heon Ha, Jae-Wook Chung, Yun-Sok Ha, Seock Hwan Choi, Bum Soo Kim, Hyun Tae Kim, Tae-Hwan Kim, Eun Sang Yoo, Tae Gyun Kwon, Sung Kwang Chung, Daugu, Korea, Republic of
Introduction: Male stress urinary incontinence is a well-recognized complication after radical prostatectomy in patients with prostate cancer. Although deterioration of storage symptoms such as urgency and frequency is also expected after radical prostatectomy, few studies have evaluated storage dysfunction such as overactive bladder (OAB) after radical prostatectomy. In this study, we evaluated an incidence of de novo OAB and the factors related to de novo OAB occurrence following radical prostatectomy.
Methods: We prospectively observed the patients without OAB who underwent radical prostatectomy for prostate cancer in our institution from October 2017 to March 2018. All the patients underwent international prostate symptom score (IPSS), overactive bladder symptom score (OABSS), and uroflowmetry before surgery and at three months after surgery. OAB was defined as a score of 1 or more of the urgency component of OABSS. At three months after radical prostatectomy, the patients were divided into two groups (OAB group and non-OAB group) on the presence of de novo OAB. We evaluated the patientsâ€™ demographics and outcomes after radical prostatectomy according to de novo OAB. Predictive factors for de novo OAB after radical prostatectomy were analyzed using a multivariate logistic regression model.
Results: Of the 50 patients without pre-operative OAB, de novo OAB was observed in 22 (44%) patients at 3 months after radical prostatectomy. De novo OAB group showed old age, high value of preoperative IPSS storage subscore, and large volume of post-void residual urine on preoperative uroflowmetry compared to non-OAB group. Multivariate analysis showed that age and preoperative IPSS storage subscore were independent predictive factors of de novo OAB after radical prostatectomy. Preoperative risk stratification for prostate cancer, method of radical prostatectomy (open vs robot), and pathological results were not related with de novo OAB following radical prostatectomy.
Conclusions: In this study, de novo OAB was observed in 44% (22/50) patients at 3 months after radical prostatectomy. Age and preoperative IPSS storage subscore were found to be independent predictive factors of de novo OAB following radical prostatectomy.