Premium
Impact of radical prostatectomy on bladder function as demonstrated on urodynamics study—A systematic review
Author(s) -
Yao Henry H.,
Hoe Venetia,
Crump Robert T.,
Sengupta Shomik,
O'Connell Helen E.,
Carlson Kevin V.,
Baverstock Richard J.
Publication year - 2021
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.24606
Subject(s) - medicine , bladder outlet obstruction , urology , prostatectomy , guideline , meta analysis , systematic review , surgery , medline , prostate , pathology , cancer , political science , law
Abstract Aims This study aims to describe the effects of radical prostatectomy (RP) on bladder function by performing a systematic review of urodynamics study findings before and after RP. Methods This systematic review was conducted in accordance with the PRISMA guideline and registered on PROSPERO (CRD42020206844). A systematic search was conducted using PubMed, Cochrane, and Embase. Studies were included if they involved men who underwent RP and had urodynamics study performed preoperatively, postoperatively, or both. Studies that included only subgroups of patients based on symptoms were excluded. Three hundred and four articles were screened, with 20 articles included. A qualitative analysis was performed. Results The rate of baseline bladder outlet obstruction (BOO) pre‐RP was 19%–67%. All six studies with comparative data pre‐ and postoperatively demonstrated a decrease in the rate of patients with equivocal or clear obstruction. The baseline rates of detrusor overactivity (DO) varied widely from 11% to 61.2%. Six of eight studies with 6 months or more follow‐up showed an improvement in the rates of DO ranging from 3.0% to 12.5%. The rate of de novo DO ranged from 0% to 54.5%. Four studies reported an increased rate of impaired bladder contractility and two of three studies showed a worsening rate of impaired bladder compliance following RP. This review is limited by the absence of level I/II studies. Conclusions Urodynamics study shows that BOO is improved following RP in most patients. RP resolves DO in some patients and cause de novo DO in others. The net effect is a reduced overall rate of DO in most studies. Bladder compliance and contractility may be impaired after RP.