MP31-12 PREVALENCE AND PREDICTIVE FACTORS OF DE NOVO DETRUSOR UNDERACTIVITY AFTER ROBOT-ASSISTED RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Non-neurogenic Voiding Dysfunction I1 Apr 2017MP31-12 PREVALENCE AND PREDICTIVE FACTORS OF DE NOVO DETRUSOR UNDERACTIVITY AFTER ROBOT-ASSISTED RADICAL PROSTATECTOMY Junya Hata, Kanako Matsuoka, Yuichi Sato, Hidenori Akaihata, Masao Kataoka, Soichiro Ogawa, Nobuhiro Haga, Kei Ishibashi, Ken Aikawa, and Yoshiyuki Kojima Junya HataJunya Hata More articles by this author , Kanako MatsuokaKanako Matsuoka More articles by this author , Yuichi SatoYuichi Sato More articles by this author , Hidenori AkaihataHidenori Akaihata More articles by this author , Masao KataokaMasao Kataoka More articles by this author , Soichiro OgawaSoichiro Ogawa More articles by this author , Nobuhiro HagaNobuhiro Haga More articles by this author , Kei IshibashiKei Ishibashi More articles by this author , Ken AikawaKen Aikawa More articles by this author , and Yoshiyuki KojimaYoshiyuki Kojima More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.966AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Radical prostatectomy (RP) damages the anatomical and functional structure of bladder and consequently induces postoperative not only urinary incontinence but also impaired detrusor contractility. The reported prevalence of detrusor underactivity (DU) after retropubic RP (RRP) ranges from 25% to 34%, but the incidence and predictive factors of de novo DU after RRP has remained unknown. This prospective study compares urodynamic parameters and detrusor function in patients before and one month after undergoing robot-assisted RP (RARP) and determines the prevalence and predictive factors of de novo DU arising in patients during the early postoperative period after RARP. METHODS Urodynamic parameters were compared before and one month after RARP in 63 patients (mean age, 66.8 ± 4.7 years). DU was defined as a maximum flow rate (Qmax) of ≤ 15 mL/s and detrusor pressure at Qmax (PdetQmax) ≤ 25 cmH20 during attempted voiding. The incidence of pre- and post-operative DU was initially assessed and then predictive factors of postoperative DU were determined using univariate and multivariate logistic regression analyses. The factors comprised patient characteristics (age, body mass index, prostate volume, etc.), operative factors (surgical duration, estimated blood loss, nerve-sparing, etc.) and pre-operative urodynamic study (UDS) parameters (maximum bladder capacity, bladder compliance, detrusor overactivity, Qmax, PdetQmax, bladder contractile index (BCI), etc.). RESULTS Preoperative and postoperative DU at one month after RARP were detected in one (1.6%) and 24 (37.5%) patients, respectively. Univariate analysis selected preoperative Qmax (p = 0.02), PdetQmax (p = 0.04) and BCI (p < 0.01) as predictors of postoperative DU (univariate odds ratios; 0.83, 0.97 and 0.94, respectively). Multivariate analyses of factors identified as significant in univariate analyses associated only preoperative BCI with postoperative DU (p < 0.01; multivariate odds ratio: 0.94). A cutoff value of 101.3 offered the optimal accuracy in receiver operating characteristics analysis. Patient characteristics and operative factors were not significantly associated with postoperative DU in both univariate and multivariate analyses. CONCLUSIONS A comparatively high prevalence of de novo DU was observed in patients at 1 month after RARP bladder, which may have been due to bladder denervation during surgery. Preoperative BCI is the most important factor for predicting early postoperative DU after RARP. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e403 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Junya Hata More articles by this author Kanako Matsuoka More articles by this author Yuichi Sato More articles by this author Hidenori Akaihata More articles by this author Masao Kataoka More articles by this author Soichiro Ogawa More articles by this author Nobuhiro Haga More articles by this author Kei Ishibashi More articles by this author Ken Aikawa More articles by this author Yoshiyuki Kojima More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...