Urodynamic assessment of bladder and urethral sphincter function before and after robot-assisted radical prostatectomy

Abstract

IntroductionAffectation of the bladder after open prostatectomy is demonstrated. Decrease in bladder capacity and bladder compliance, detrusor hyper-or hypo-activity and voiding dysfunction are observed. We propose to investigate the effects of robotic surgery on bladder and sphincter function through the comparative study of preoperative and postoperative urodynamic values 3months after prostatectomy. Material and methodsProspective study of 32consecutive patients undergoing robotic prostatectomy. They all underwent urodynamic study one month before the intervention and 3months after the radical prostatectomy. ResultsTwenty-five percent of patients undergoing robotic prostatectomy showed detrusor hyperactivity accompanied by a decrease in bladder compliance of 30.2 to 21.8ml/cmH2O. Urethral profile showed diminished functional length of 67 to 44mm and decreased maximum urethral pressure of 48.5 to 29.3cmH2O. After robotic prostatectomy 21.8% of patients had detrusor hypoactivity, obstruction decreased between 28.1 and 12.5%. ConclusionsDecreased bladder compliance, detrusor hypo- or hyperactivity and obstruction improvement observed in the study of the flow pressure have been associated with sphincter involvement. It is part of the complex of lower urinary tract dysfunction that occurs after robotic prostatectomy.