Longitudinal observational cohort study about detrusor underactivity as a risk factor for bladder neck contracture after retropubic radical prostatectomy: preliminary results

Mucciardi, Giuseppe; Galı̀, Alessandro; Inferrera, Antonino; Benedetto, Antonina Di; Macchione, Luciano; Mucciardi, Massimo; Magno, Carlo

doi:10.1007/s11255-013-0426-y

Cited by 11 publications

(40 citation statements)

References 15 publications

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“…A total of 827 studies were screened, 62 identified as relevant and 27 initially qualified for synthesis [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ] ( Figure 1 ). Populations from three [ 26 , 27 , 28 ] of the last-mentioned studies were, however, substantially overlapped (72% to 90%, based on data obtained from the author), which led to further exclusions [ 27 , 28 ].…”

Section: Resultsmentioning

confidence: 99%

De Novo Detrusor Underactivity and Other Urodynamic Findings after Radical Prostatectomy: A Systematic Review

et al. 2022

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Background and objectives: The aim of this systematic review is to evaluate the impact of radical prostatectomy (RP) on bladder function, with special attention towards detrusor underactivity investigated with the means of urodynamic evaluation. Materials and Methods: The review was performed in accordance with the PRISMA statement and was registered in the PROSPERO (ID#: CRD42020223480). The studied population was limited to men with prostate cancer who underwent urodynamic study prior to and after radical prostatectomy. Eight hundred twenty-seven studies were screened, with twenty-five finally included. A qualitative analysis was performed. Rates of detrusor underactivity (DU) before surgery were reported in eight studies and ranged from 1.6% to 75% (median of 40.8%). DU occurred de novo after RP in 9.1% to 37% of patients (median of 29.1%). On the other hand, preexisting DU resolved in 7% to 35.5% of affected men. Detrusor overactivity (DO) was the most frequently reported outcome, being assessed in 23 studies. The rate of DO preoperatively was from 5% to 76% (median of 25%). De novo was reported in 2.3–54.4% of patients (median of 15%) and resolved after RP in 19.6% to 87.5% (median of 33%) of affected patients. Baseline rates of bladder outlet obstruction (BOO) varied between studies from 19% to 59.3%, with a median of 27.8%. The most pronounced change after surgery was the resolution of BOO in 88% to 93.8% (median of 92%) of affected patients. Results: Rates of de novo impaired bladder compliance (IBC) varied from 3.2% to 41.3% (median of 13.3%), whereas the resolution of IBC was reported with rates ranging from 0% to 47% (median of 4.8%). Conclusions: BOO, DO, and DU are frequently diagnosed in men scheduled for RP. BOO is improved after RP in most patients; however, there is still a substantial rate of patients with de novo DU as well as DO which may impair functional outcomes and quality of life.

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Section: Resultsmentioning

confidence: 99%

De Novo Detrusor Underactivity and Other Urodynamic Findings after Radical Prostatectomy: A Systematic Review

et al. 2022

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“…10 Studies have shown persistently higher rates of poor bladder compliance post-RP even at 6-12 months. 10,15,16 Similarly, bladder contractility appears to be impaired post-RP 10,12,26,27 and can persist at 12 months. 26 Giannantoni et al 12 found bladder compliance and contractility to be worse at 8 months following RP, but both improved at 36 months.…”

Section: Maximum Cystometric Capacity (Mcc)mentioning

confidence: 99%

Impact of radical prostatectomy on bladder function as demonstrated on urodynamics study—A systematic review

Yao

Hoe

Crump

et al. 2021

Neurourology and Urodynamics

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Aims: This study aims to describe the effects of radical prostatectomy (RP) on bladder function by performing a systematic review of urodynamics study findings before and after RP. Methods: This systematic review was conducted in accordance with the PRISMA guideline and registered on PROSPERO (CRD42020206844). A systematic search was conducted using PubMed, Cochrane, and Embase. Studies were included if they involved men who underwent RP and had urodynamics study performed preoperatively, postoperatively, or both. Studies that included only subgroups of patients based on symptoms were excluded. Three hundred and four articles were screened, with 20 articles included. A qualitative analysis was performed. Results: The rate of baseline bladder outlet obstruction (BOO) pre-RP was 19%-67%. All six studies with comparative data pre-and postoperatively demonstrated a decrease in the rate of patients with equivocal or clear obstruction. The baseline rates of detrusor overactivity (DO) varied widely from 11% to 61.2%. Six of eight studies with 6 months or more follow-up showed an improvement in the rates of DO ranging from 3.0% to 12.5%. The rate of de novo DO ranged from 0% to 54.5%. Four studies reported an increased rate of impaired bladder contractility and two of three studies showed a worsening rate of impaired bladder compliance following RP. This review is limited by the absence of level I/II studies. Conclusions: Urodynamics study shows that BOO is improved following RP in most patients. RP resolves DO in some patients and cause de novo DO in others. The net effect is a reduced overall rate of DO in most studies. Bladder compliance and contractility may be impaired after RP.

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“…In contrast, there are few reports on detrusor underactivity (DU) after RP. [1][2][3] However, according to several articles, including the present report, it is clear that RP causes postoperative DU. 4 The authors reported that even robot-assisted RP (RARP), which is superior to other techniques in terms of functional outcome, causes DU.…”

Section: Editorial Commentmentioning

confidence: 47%

Editorial Comment to Prevalence and predictors of postoperative detrusor underactivity after robot‐assisted radical prostatectomy: A prospective observational study

Nohara

2021

Int J of Urology

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Longitudinal observational cohort study about detrusor underactivity as a risk factor for bladder neck contracture after retropubic radical prostatectomy: preliminary results

Abstract: We identify DU as a possible novel risk factor for BNC formation after radical prostatectomy that may contribute to its development.

Cited by 11 publications

References 15 publications

De Novo Detrusor Underactivity and Other Urodynamic Findings after Radical Prostatectomy: A Systematic Review

De Novo Detrusor Underactivity and Other Urodynamic Findings after Radical Prostatectomy: A Systematic Review

Impact of radical prostatectomy on bladder function as demonstrated on urodynamics study—A systematic review

Editorial Comment to Prevalence and predictors of postoperative detrusor underactivity after robot‐assisted radical prostatectomy: A prospective observational study

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