Quantification of Long Term Stability and Specific Relief of Lower Urinary Tract Symptoms (LUTS) after Robot-Assisted Radical Prostatectomy.

OBJECTIVE - To assist in preoperative counseling by assessing long-term changes in AUA symptom scores (AUAss) and lower urinary tract symptom (LUTS)-related quality of life (QoL) in patients undergoing robot-assisted radical prostatectomy (RARP).

METHODS - RARP was performed on 666 men, by one surgeon from 2002-2007 at a single institution. AUAss and QoL were queried preoperatively and at 3, 9, 15, 24-48, 60-84, and 96+ months postoperatively. LUTS subgroups were compared pre/post surgery using univariate and multivariate statistics.

RESULTS - The mean and median follow up for all responders was 3.0 and 2.4 years. Pad free continence at 12 months was 89%. A subset of 174 men reported preoperative and long-term responses; average follow-up was 5.8 years (Range 4.0- 10.3 Yrs). AUAss for all men declined from baseline to 5 Years by 3.7 (8.6 to 4.8) while QoL/bother scores decreased by 0.5 (1.7 to 1.2), all p < .05. Men with baseline mild LUTS remained clinically unchanged at long term AUAss. Individuals with moderate/severe preoperative LUTS had marked improvements in AUA and QOL scores, all p ≤ 0.05.

CONCLUSIONS - Men with mild LUTS have short term increases in AUAss but most return to baseline and are stable at 5 years. Benefits were found for men with preoperative moderate/severe LUTS in that 63% had significant QOL improvements and 68% reduced their AUAss to mild LUTS, persisting years after RARP. This study suggests that certain patients with preoperative urinary symptoms and bother may experience improvements in lower urinary tract symptoms and associated QoL after RARP.

Urology. 2016 Mar 30 [Epub ahead of print]

Adam Gordon, Douglas Skarecky, Kathryn Osann, Louis Eichel, Harleen Dhaliwal, Blanca Morales, Thomas Ahlering

Department of Urology, University of California, Irvine., Department of Urology, University of California, Irvine. Department of Urology, University of California, Irvine., Department of Urology, University of California, Irvine., Department of Urology, University of California, Irvine., Department of Urology, University of California, Irvine., Department of Urology, University of California, Irvine.

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