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The impact of nerve‐sparing robot‐assisted radical prostatectomy on lower urinary tract function: Prospective assessment of patient‐reported outcomes and frequency volume charts
Author(s) -
Haga Nobuhiro,
Hata Junya,
Matsuoka Kanako,
Koguchi Tomoyuki,
Akaihata Hidenori,
Kataoka Masao,
Sato Yuichi,
Ogawa Soichiro,
Ishibashi Kei,
Kojima Yoshiyuki
Publication year - 2018
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.23297
Subject(s) - medicine , prostatectomy , international prostate symptom score , lower urinary tract symptoms , urology , erectile function , erectile dysfunction , nocturia , quality of life (healthcare) , urinary system , prostate , surgery , nursing , cancer
Aims To elucidate the effects of a nerve‐sparing (NS) procedure on lower urinary tract symptoms (LUTS) and urinary function after robot‐assisted radical prostatectomy (RARP), the associations between the NS procedure and LUTS and urinary function were investigated. Methods The participants in this study were 200 consecutive patients who underwent RARP. These patients were categorized into unilateral and bilateral NS groups and the non‐NS group. The International Prostate Symptom Score (IPSS), quality of life (QOL) index, frequency‐volume chart, uroflowmetry, 1‐h pad test, and the 5‐item International Index of Erectile Function (IIEF‐5) questionnaire were evaluated before and after RARP. Results The total IPSS score was significantly lower in the unilateral ( P = 0.03) and bilateral NS groups ( P = 0.03) than in the non‐NS group after RARP. Diurnal maximum voided volume (MVV) values were significantly greater in the bilateral NS group than in the non‐NS group after RARP ( P = 0.002). Nocturnal frequency was significantly decreased in the unilateral NS group than in the non‐NS group after RARP (3 months P = 0.01, 12 months P = 0.01). Erectile function was significantly better in both the unilateral NS group ( P < 0.0001) and the bilateral NS group ( P = 0.02) than in the non‐NS group 12 months after RARP. Conclusions The NS procedure in RARP has the possibility to improve not only erectile function, but also LUTS, owing to both the increase of MVV and the decrease of nocturia. Therefore, the NS procedure is also recommended from the viewpoint of early improvement of LUTS and lower urinary tract dysfunction after RARP.