World J Mens Health.  2015 Dec;33(3):194-201. 10.5534/wjmh.2015.33.3.194.

Changes in Nocturia and Lower Urinary Tract Symptoms after Radical Prostatectomy

• Hur KJ
• Lee KW
• Kim SJ
• Kim KS
• Bae WJ
• Cho HJ
• Hong SH
• Lee JY
• Hwang TK
• Kim SW

• KMID: 2405148
• DOI: http://doi.org/10.5534/wjmh.2015.33.3.194

Abstract

PURPOSE
The goal of this study was to evaluate changes in nocturia and other lower urinary tract symptoms (LUTS) after laparoscopic radical prostatectomy (LRP) and robot-assisted laparoscopic radical prostatectomy (RALP).
MATERIALS AND METHODS
We reviewed the medical records of 96 patients who underwent LRP or RALP for clinically localized prostate cancer and completed the International Prostate Symptom Score (IPSS) questionnaire, which provided a basis for assessing their symptoms. We also evaluated maximal flow rate and post-void residual urine volume over a follow-up period of at least 24 months. We divided the patients into three groups according to postoperative changes in the frequency of nocturia.
RESULTS
Voiding symptoms significantly improved over the course of 24 months in patients who underwent LRP or RALP. However, most patients showed persistent or increased nocturia after LRP or RALP. Moreover, more than one third of the patients (33/96) presented with exacerbated nocturia (1.0+/-0.9 episodes of preoperative nocturia vs. 3.0+/-1.3 episodes of postoperative nocturia). Multiple regression analysis showed that preoperative IPSS storage sub-score had negative association with the nocturia after radical prostatectomy (p=0.005). However, patients' age, body mass index, preoperative prostate specific antigen, Gleason score, T-stage, and prostate volume had no association.
CONCLUSIONS
The present study showed that nocturia was influenced by a range of factors, including other storage LUTS and the relief of bladder outlet obstruction after radical prostatectomy. Moreover, the preoperative storage symptoms are regarded as an important factor which influences the changes of nocturia after radical prostatectomy.

Keyword

Laparoscopy; Lower urinary tract symptoms; Nocturia; Robotic surgical procedures

MeSH Terms

Body Mass Index
Follow-Up Studies
Humans
Laparoscopy
Lower Urinary Tract Symptoms*
Medical Records
Neoplasm Grading
Nocturia*
Prostate
Prostate-Specific Antigen
Prostatectomy*
Prostatic Neoplasms
Urinary Bladder Neck Obstruction
Prostate-Specific Antigen

Figure

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  Fig. 1 (A) Overall changes in nocturia after radical prostatectomy. (B) Preoperative and postoperative frequency of nocturia in patients who experienced exacerbated nocturia after radical prostatectomy. (C) Preoperative and postoperative frequency of nocturia in patients who experienced improved nocturia after radical prostatectomy.

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