To describe the rate of OAB and storage lower urinary tract symptoms (LUTS) following RP and determine if subsequent radiation increases the risk of OAB.
We reviewed all patients who underwent open RP at our tertiary care institution from January 2006 to June 2011. Primary outcomes were the proportion of patients with new OAB and time to development of OAB in those treated with RP alone versus RP plus radiation. Secondary outcomes included the proportion of patients treated for OAB. A Cox survival analysis was used to assess the impact of radiation on development of OAB.
Of the 875 patients who met study criteria, 19% of patients developed de novo OAB defined as urgency with or without frequency and nocturia. A total of 256 patients (29%) developed one or more urinary symptoms including nocturia (22%), frequency (21%), urgency (19%), and urge incontinence (6%) following RP. After adjusting for age, BMI, smoking status, cancer stage and nerve-sparing status, radiation therapy was associated with an increased relative hazard of OAB (5.59 (95% CI 3.63-8.61, p< 0.001). Among men classified with de novo OAB, only 41% received treatment.
OAB and storage LUTS are prevalent in men post-RP. Adjuvant or salvage radiation therapy increases the risk of developing OAB after RP. OAB may be under treated in men following prostate cancer treatment.
Urology. 2016 May 12 [Epub ahead of print]
Gregory W Hosier, Karthik K Tennankore, Jeffrey G Himmelman, Jerzy Gajewski, Ashley R Cox
Faculty of Medicine, Dalhousie University, Halifax Nova Scotia, Canada. Electronic address: ., Division of Nephrology, Dalhousie University, Halifax Nova Scotia, Canada., Department of Urology, Dalhousie University, Halifax Nova Scotia, Canada., Department of Urology, Dalhousie University, Halifax Nova Scotia, Canada., Department of Urology, Dalhousie University, Halifax Nova Scotia, Canada.