To assess whether postoperative improvement in overactive bladder (OAB) symptoms following robot-assisted radical prostatectomy (RARP) can be predicted by preoperative diagnosis of OAB and intravesical prostatic protrusion (IPP).
This retrospective study included 210 patients who underwent RARP between January 2022 and May 2024. IPP was measured by preoperative MRI and defined as ≥ 5 mm. Improvement in OAB symptoms was defined as a ≥ 2-point reduction in the Overactive Bladder Symptom Score (OABSS) at 12 months postoperatively. Univariable and multivariable logistic regression analyses were conducted to determine predictive factors.
At 12 months postoperatively, 46 (21.9%) patients demonstrated an improvement in OABSS. Multivariable analysis identified preoperative meeting criteria for OAB (odds ratio [OR]: 7.60; 95% confidence interval [CI]: 3.59-16.10; p < 0.0001) and meeting criteria for IPP (OR: 3.49; 95% CI: 1.57-7.78; p = 0.0023) as independent predictors. In the entire cohort, no significant changes in the median OABSS were observed before and after RARP. In contrast, in the group that met both criteria, the median OABSS changed from 6 (IQR, 5.75-7) preoperatively to 4 (IQR, 3.75-6.5) at 12 months postoperatively (p = 0.032).
Preoperative OAB diagnosis and IPP can predict postoperative improvement in OABSS. Our study demonstrates that preoperative OABSS and IPP status permit stratification of prostate cancer patients most likely to experience OAB symptom relief following RARP. This finding may further assist in individualized surgical counseling and treatment selection for patients.
International journal of urology : official journal of the Japanese Urological Association. 2026 Apr [Epub]
Yasukazu Nakanishi, Gaku Okumura, Erika Ikezoe, Shu Gozu, Naoki Imasato, Kohei Hirose, Madoka Kataoka, Shugo Yajima, Hitoshi Masuda
Department of Urology, National Cancer Center Hospital East, Chiba, Japan.