1195 LONGITUDINAL BLADDER HEALTH OUTCOMES IN MEN MANAGED WITH EXTIRPATIVE SURGERY FOR PROSTATIC DISEASE

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Incontinence - Evaluation & Therapy II1 Apr 20121195 LONGITUDINAL BLADDER HEALTH OUTCOMES IN MEN MANAGED WITH EXTIRPATIVE SURGERY FOR PROSTATIC DISEASE Jove Graham and Daniel Rukstalis Jove GrahamJove Graham Danville, PA More articles by this author and Daniel RukstalisDaniel Rukstalis Danville, PA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1440AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Declining bladder health in aging men, as manifest by LUTS, represents a progressive disorder primarily related to outlet obstruction from prostatic enlargement. While many therapeutic options exist, there is a paucity of patient questionnaire-based longitudinal data to help physicians determine optimal treatments for men over time. Since extirpative procedures are the standard for BPH management, we compared longitudinal data on bladder health for men treated for BPH relative to men treated with radical prostatectomy. METHODS Patients in our urology clinic are asked to fill out the International Prostate Symptom Score (IPSS) at every visit to assess urinary function, and data are entered in a prospective registry. We performed an IRB-approved retrospective analysis of n=3,349 responses from 608 male patients ages 50-79 to compare IPSS scores after procedures for BPH (laser prostectomy, TEVAP or transurethral prostatectomy, n=190) versus robotic radical prostatectomy (RRP) for prostate cancer (n=418) between 2004 and 2011. Patients were stratified into 9 groups by age (50-59, 60-69 and 70-79) and IPSS score prior to surgery (<10, 10-19 and 20-29). Within each stratum, longitudinal outcomes were plotted and median scores were compared between BPH vs. RRP surgery types at 1 and 2 years of followup. RESULTS In 7 of 9 strata, median IPSS scores were almost identical between BPH and RRP patients at 1 and 2 years post-surgery. In the two oldest and most severe symptom groups (age 60-69 and 70-79 with IPSS>20), however, RRP patients had much better median IPSS scores than BPH patients at 2 years (8 vs. 14 and 6 vs. 12, respectively), though these differences did not reach statistical significance (p=0.14). CONCLUSIONS Extirpative procedures of the prostate result in significant improvements in voiding symptoms and bladder health in men of all ages, which is important for men with expected longevity. Importantly, complete removal of the prostate is comparable to endoscopic BPH treatments in men with young age or moderate symptoms but is more effective than BPH treatment in older men with more severe symptoms. This information may support the choice of radical prostatectomy in men with significant LUTS. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e484 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jove Graham Danville, PA More articles by this author Daniel Rukstalis Danville, PA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...