The aim was to investigate the incidence and clinical predictive factors of de novo overactive bladder (OAB) after robot-assisted radical prostatectomy (RARP), including a Retzius-sparing (RS) approach, in the same period at a single institution.
Of a total of 113 patients with localized prostate cancer, 81 received conventional RARP (CON-RARP) and 32 received RS-RARP at our institution. The basic characteristics data of patients and self-assessment questionnaires, including IPSS and OABSS, were obtained preoperatively and 1, 3, and 6 months after RARP. In addition, a retrospective biomarker analysis was also performed of predictive clinical parameters obtained from cystography that included a postoperative bladder neck to pubic symphysis (BNPS) ratio.
Patients' basic characteristics were similar between CON-RARP and RS-RARP groups. With respect to the surgical procedure, anastomosing time was found to be significantly longer for patients in the RS-RARP compared to the CON-RARP group (p < 0.01). Compared to the CON-RARP group, the RS-RARP group showed a significantly lower postoperative BNPS and aspect ratio (p < 0.001). The incidence of de novo OAB in patients of the CON-RARP group was greater than for those in the RS-RARP group (40.7% CON-RARP vs. 25.0% RS-RARP), though this was not significant. Regarding the emergence of de novo OAB, the following were revealed in univariate analysis to be independent prognostic factors: age > 64 years (hazards ratio [HR]: 4.32, 95% confidence interval [CI]: 1.51-12.3), postoperative BNPS ratio > 0.44 (HR: 8.7, 95% CI: 6.43-54.5), postoperative aspect ratio > 1.18 (HR: 3.36, 95% CI: 1.49-7.61). Additionally, multivariate analysis identified a sole significant prognostic factor: postoperative BNPS ratio > 0.44 (HR: 13.3, 95% CI: 4.33-41.1).
Our findings indicate that the postoperative BNPS ratio may be a practical predictive indicator of the emergence of de novo OAB after RARP.
Diagnostics (Basel, Switzerland). 2023 Oct 11*** epublish ***
Nayuka Matsuyama, Taku Naiki, Shuzo Hamamoto, Yosuke Sugiyama, Yasue Kubota, Takashi Hamakawa, Toshiki Etani, Shoichiro Iwatsuki, Kazumi Taguchi, Yuya Ota, Masakazu Gonda, Maria Aoki, Toshiharu Morikawa, Taiki Kato, Atsushi Okada, Takahiro Yasui
Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Nagoya 467-8601, Japan., Department of Pharmacy, Nagoya City University Hospital, Nagoya 467-8601, Japan., Department of Clinical Physiology, Graduate School of Nursing, Nagoya City University, Nagoya 467-8601, Japan., Department of Urology, Nagoya City University West Medical Center, Nagoya 462-8508, Japan., Department of Urology, Nagoya City University East Medical Center, Nagoya 464-8547, Japan.