Impact of radiotherapy for localized prostate cancer on bladder function as demonstrated on urodynamics study: A systematic review

Abstract

Introduction: This study aimed to describe the effects of bladder function following radiotherapy for localized prostate cancer by performing a systematic review on studies reporting on urodynamic findings after radiotherapy.
 Methods: This systematic review was conducted in accordance with PRISMA guidelines. The review protocol was registered at PROSPERO (CRD42021229037). A systematic search was conducted using PubMed, Cochrane Library, Scopus, and OVID Embase. Studies were included if they involved men who underwent urodynamic studies following radiotherapy for localized prostate cancer. A total of 798 articles were screened and five articles included. A qualitative analysis was performed.
 Results: Bladder compliance appears to be impaired following radiotherapy, especially with longer followup. Impaired bladder compliance was reported in 18.8–62.5% of patients following radiotherapy. Bladder capacity was found to be statistically significantly lower following radiotherapy compared to pre-radiotherapy, and when compared with patients who did not undergo pelvic radiotherapy. Bladder outlet obstruction (BOO) persists post-radiotherapy in most patients at three and 18 months post-radiotherapy. De novo detrusor overactivity (DO) of 13.3% has been reported at 18 months post-radiotherapy. This review is limited by the absence of level I/II studies.
 Conclusions: Radiotherapy for localized prostate cancer results in decreased bladder compliance and capacity demonstrated on urodynamic studies. Resolution of BOO appears less likely in comparison to series on radical prostatectomy. De novo DO may develop following radiotherapy, especially with longer followup. With only low level of evidence studies available at present, further high-quality, prospective studies are important to elucidate the impact of radiotherapy on bladder and urethral function.

Longitudinal deterioration in lower urinary tract symptoms after artificial urinary sphincter implantation in patients with a history of pelvic radiation therapy

“…In particular, storage symptoms might be more affected by pelvic RT than voiding symptoms, which was indicated by the significant deterioration of OABSS and VV, although no significant changes were observed in individual items of IPSS regarding storage symptoms, probably due to the small size of the cohort. One possible explanation is that RT reduces bladder compliance over time due to fibrosis of the detrusor and impairment of blood flow, 20 which results in the longitudinal deterioration of storage functions and symptoms. Nevertheless, RT should not be considered as a contraindication of AUS implantation, because significant improvements of UI and QOL could not be obtained without AUS in patients with severe UI.…”

What Do We Have to Know about PD-L1 Expression in Prostate Cancer? A Systematic Literature Review (Part 6): Correlation of PD-L1 Expression with the Status of Mismatch Repair System, BRCA, PTEN, and Other Genes

“…Systematic literature reviews and metanalyses (SLRs) conducted according to the PRISMA guidelines (including an evidence-based minimum set of items for reporting) ( , accessed on 8 May 2021) are increasingly important in health care, keeping medical doctors up to date, and also representing the background for developing clinical guidelines/trials, as well as the justification for financial supports of research projects. Usually conducted by multidisciplinary teams, SLRs performed according to these guidelines could be applicable in various topics/contexts, improving the research quality not only of pure meta-analyses but also of SLRs applied to case report/series [ 215 , 216 , 217 , 218 , 219 , 220 , 221 , 222 , 223 , 224 , 225 , 226 , 227 , 228 , 229 , 230 , 231 , 232 , 233 , 234 , 235 , 236 , 237 , 238 , 239 , 240 , 241 , 242 , 243 , 244 , 245 , 246 , 247 , 248 , 249 , 250 , 251 , 252 , 253 , 254 , 255 , 256 , …”

Urodynamics in the Transplant Population

“…This is perhaps a result of the discrepancy in the mean age of KT (44) and pelvic interventions that can lead to BOO such as radical prostatectomy, anti-incontinence surgeries, and pelvic radiation for various malignancies, which typically occur in the 5th to 7th decades of life [42][43][44][45]. In non-KT patients, a systematic review of post-radiotherapy prostate cancer patients by Yao et al in 2021 found significantly reduced bladder capacities compared to non-radiated patients, as well as impaired bladder compliance in 18.8-62.5% and de novo DO in 13.3% of patients [46]. The significance of these UDS findings on outcomes or management is unknown.…”