PURPOSE: The prevalence of lower urinary tract symptoms (LUTS) increases with age and impairs quality of life.
Radical prostatectomy (RP) has been shown to relieve LUTS at short-term follow-up. The long-term effect of RP on LUTS is unclear.
MATERIALS AND METHODS: We performed a prospective cohort study of 1788 men undergoing RP. Progression of scores from the self-administered American Urological Association Symptom Index (AUASS) preoperatively and at three, six, 12, 24, 48, 60, 84, 96, and 120 months were analyzed using models controlling for preoperative AUASS, age, PSA, Gleason score, pathologic stage, nerve sparing, race, and marital status. This model was also applied to patients stratified by baseline clinically significant (AUASS>7) and insignificant (AUASS≤ 7) LUTS.
RESULTS: Men exhibited an immediate worsening of LUTS that improved between three months and two years post-RP. Overall, the difference between mean AUASS at baseline and 10 years were not statistically or clinically significant. Men with baseline clinically significant LUTS experienced immediate improvements in LUTS that lasted until 10 years post-RP (13.5 vs. 8.81, p< 0.001). Men with baseline clinically insignificant LUTS experienced a statistically significant but clinically insignificant increase in mean AUASS (3.09 to 4.94, p< 0.001). The percentage of men with clinically significant LUTS declined from baseline to 10 years post-RP (p = 0.02).
CONCLUSIONS: RP is the only treatment for prostate cancer shown to improve and prevent the development of LUTS at long-term follow-up. This previously unrecognized long-term benefit argues in favor of the prostate as the primary contributor to male LUTS.
Written by:
Prabhu V, Taksler GB, Sivarajan G, Laze J, Makarov DV, Lepor H. Are you the author?
Department of Urology, New York University School of Medicine, New York, New York.
Reference: J Urol. 2013 Aug 13. pii: S0022-5347(13)05124-0.
doi: 10.1016/j.juro.2013.08.010
PubMed Abstract
PMID: 23954581
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