To clarify longitudinal change of lower urinary tract symptoms (LUTS) and various types of urinary incontinence following robot-assisted radical prostatectomy (RARP) using validated questionnaires.
The core lower urinary tract symptom score (CLSS) and the International Consultation on Incontinence Questionnaire (ICIQ)-Short Form (SF) questionnaires were administered to 607 consecutive, treatment-naïve men receiving RARP before and after surgery. The time course of comprehensive LUTS and various types of urinary incontinence, including stress-, urgency-, and urinary incontinence with no obvious reason, were evaluated. Continence recovery rates were compared for the different types of incontinence using Cox hazard regression analysis.
After surgery, stress urinary incontinence (SUI) was reported most frequently (32% of cases) as the chief complaint with the most impact on daily life, as assessed by the CLSS questionnaire, followed by urgency urinary incontinence (UUI; 27% of cases). The rates of continence recovery differed among the different types of urinary incontinence, such as after urinating, when dressed, when asleep, when physically active or exercising, when coughing or sneezing, before reaching the toilet, and for no obvious reason. Incontinence for no obvious reason at 1 month after RARP was a strongest prognostic factor of delayed continence recovery (hazard ratio, 0.61; P < 0.0001), whereas patients reporting SUI and UUI gradually regained continence.
Further time course on continent recovery after RARP would be more precisely predictable based on the incontinence status at one month postoperatively. Especially, incontinence with no obvious reason would be a significant factor for delayed recovery.
Neurourology and urodynamics. 2019 Mar 14 [Epub]
Tetsuya Fujimura, Yasuhiko Igawa, Naoki Aizawa, Aya Niimi, Yuta Yamada, Toru Sugihara, Jun Kamei, Yusuke Sato, Akiko Matsunaga, Mikako Yoshida, Yusuke Shinoda, Hiroshi Fukuhara, Tohru Nakagawa, Yukio Homma, Haruki Kume
Department of Urology, Jichi Medical University, Yakushiji, Simotsuke-shi, Tochigi, Japan., Department of Continence Medicine, Graduate School of Medicine, The University of Tokyo, Japan., Department of Urology, Graduate School of Medicine, The University of Tokyo, Japan., Department of Rehabilitation, Graduate School of Medicine, The University of Tokyo, Japan., Department of Gerontological Nursing/ Wound Care Management, Graduate School of Medicine, The University of Tokyo, Japan., Department of Urology, Kyorin University, Tokyo, Japan., Department of Urology, Teikyo University School of Medicine, Tokyo, Japan., President Japanese Red Cross Medical Center, Tokyo, Japan.