Abstract
Radical prostatectomy can alter the anatomy of the urinary bladder. We aimed to evaluate bladder function before and 4 months after radical prostatectomy using the urodynamic test and overactive bladder (OAB) symptom score. Among 70 prospectively enrolled patients, 61 patients completed the study. In the urodynamic test, bladder capacity and compliance did not change, the frequency of involuntary detrusor contraction decreased, the maximum flow rate and bladder outlet obstruction index improved, and the maximum urethral closure pressure (MUCP) deteriorated. Further evaluation of urodynamic parameters according to changes in symptoms was made. Although change in bladder compliance was correlated with changes in OAB symptoms, not the relative change of bladder compliance but the relative change in the MUCP was reliable factor when OAB symptoms were deteriorated. In general, prostatectomy did not deteriorate the condition of the detrusor; rather, change in the MUCP could be responsible for postprostatectomy OAB.
Highlights
Radical prostatectomy can alter the anatomy of the urinary bladder
We usually use magnetic resonance imaging of the prostate when prostate-specific antigen levels are elevated in patients who have undergone prostatectomy, which often shows that the lower portion of the urinary bladder is pulled downward without shortening of the functional urethral length (Fig. 1)
We hypothesized that the urodynamic parameters of the storage phase, including bladder compliance and involuntary bladder contraction, would deteriorate after radical prostatectomy, which could contribute to overactive bladder (OAB) symptoms
Summary
Radical prostatectomy can alter the anatomy of the urinary bladder. We aimed to evaluate bladder function before and 4 months after radical prostatectomy using the urodynamic test and overactive bladder (OAB) symptom score. Prostatectomy did not deteriorate the condition of the detrusor; rather, change in the MUCP could be responsible for postprostatectomy OAB. Matsukawa et al suggested a urogenital mechanism in which the maximum urethral closure pressure (MUCP) plays a key role in generating OAB9. Other possibilities, such as bladder outlet obstruction (BOO) or deterioration of the detrusor’s condition, including detrusor overactivity (DO), should be considered in the development of postprostatectomy O AB10,11. We hypothesized that the urodynamic parameters of the storage phase, including bladder compliance and involuntary bladder contraction, would deteriorate after radical prostatectomy, which could contribute to OAB symptoms
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