Changes in Nocturia and Lower Urinary Tract Symptoms after Radical Prostatectomy

• Published in: The world journal of men's health Vol. 33; no. 3; pp. 194 - 201
• Main Authors: Hur, Kyung Jae, Lee, Kyu Won, Kim, Su Jin, Kim, Kang Sup, Bae, Woong Jin, Cho, Hyuck Jin, Hong, Sung Hoo, Lee, Ji Youl, Hwang, Tae Kon, Kim, Sae Woong
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society for Sexual Medicine and Andrology 01-12-2015; 대한남성과학회
• Subjects: Bladder; Body mass index; Laparoscopy; Nocturia; Original; Prostate cancer; Quality of life; Regression analysis; Robots; Surgery; Urinary incontinence; Urogenital system; 비뇨기과학; Laparoscopy; Lower urinary tract symptoms; Robotic surgical procedures; Nocturia
• ISSN: 2287-4208; 2287-4690
• DOI: 10.5534/wjmh.2015.33.3.194

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).
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.
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.
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.