Analysis of Improved Urinary Peak Flow Rates After Robot-Assisted Radical Prostatectomy

Skarecky, Douglas; Gordon, Adam M.; Babaian, Kara N.; Dhaliwal, Harleen; Morales, Blanca; Ahlering, Thomas E.

doi:10.1089/end.2015.0353

Cited by 8 publications

(5 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Skarecky et al reported that the maximum flow rate on uroflowmetry improved significantly after RARP. [ 25 ] As just described, it is generally considered that the maximum flow rate after radical prostatectomy would be improved by removing the bladder outlet obstruction. The reason why the maximum flow rate was not significantly improved in the present study is that the true result might have been masked by the small sample size.…”

Section: Discussionmentioning

confidence: 99%

The Effect of the Vesical Adaptation Response to Diuresis on Lower Urinary Tract Symptoms after Robot-Assisted Laparoscopic Radical Prostatectomy: A Pilot Proof of Concept Study

et al. 2016

View full text Add to dashboard Cite

BackgroundWhen urine output increases, voided volume at each voiding also increases in normal subjects. This is generally understood as a vesical adaptation response to diuresis (VARD). Because lower urinary tract symptoms (LUTS) are supposed to be improved by the change in bladder function after robot-assisted laparoscopic radical prostatectomy (RARP), the aim of the present study was to investigate whether VARD is involved in the improvement of LUTS after RARP.Methods100 consecutive patients who underwent RARP and had the International Prostate Symptom Score (IPSS), quality of life (QOL) index, a frequency-volume chart (FVC), uroflowmetry, and post-voided residual urine (PVR) available were evaluated before and after RARP. This cohort was divided into patients with and without preoperative LUTS according to the preoperative IPSS total score. VARD was defined as the presence of a significant correlation between the urine output rate and voided volume at each voiding (R2>0.2).ResultsIn patients with preoperative LUTS, the IPSS total, storage, and voiding symptom scores were significantly improved after RARP (all P<0.001). The QOL index was also significantly improved after RARP (P<0.05). Although VARD was not seen before RARP (R2 = 0.05), it was seen after RARP (3 months R2 = 0.22, 12 months R2 = 0.23). PVR was significantly reduced after RARP (P = 0.004).ConclusionsImprovement of LUTS was seen with acquisition of VARD after RARP. As a result, urinary QOL was also improved in patients with preoperative LUTS. RARP might be an effective procedure for amelioration of LUTS by the acquisition of VARD.

show abstract

Section: Discussionmentioning

confidence: 99%

The Effect of the Vesical Adaptation Response to Diuresis on Lower Urinary Tract Symptoms after Robot-Assisted Laparoscopic Radical Prostatectomy: A Pilot Proof of Concept Study

et al. 2016

View full text Add to dashboard Cite

show abstract

“…21,28 RARP additionally contributes to improved urinary peak flow rates across all 3 LUTS groups. 29 Men who choose an active monitoring protocol, radiation, 30 or hormonal therapies remain at risk for declining urinary function in the form of reduced daily QOL and the subsequent risk of treatment by transurethral resection of the prostate or chronic α-blocker therapy. These findings should be shared with prostate cancer patients whose LUTS already have a negative impact on their daily QOL.…”

Section: Discussionmentioning

confidence: 99%

Quantification of Long-term Stability and Specific Relief of Lower Urinary Tract Symptoms (LUTS) After Robot-assisted Radical Prostatectomy

Gordon

Skarecky

Osann

et al. 2016

Urology

Self Cite

View full text Add to dashboard Cite

OBJECTIVE To assist in preoperative counseling by assessing long-term changes in American Urological Association symptom scores (AUAss) and lower urinary tract symptom (LUTS)-related quality of life (QOL) in patients undergoing robot-assisted radical prostatectomy (RARP). MATERIALS AND METHODS RARP was performed on 666 men by one surgeon from 2002 to 2007 at a single institution. AUAss and QOL were queried preoperatively and at 3, 9, 15, 24–48, 60–84, and 96+ months postoperatively. LUTS subgroups were compared pre-/postsurgery using univariate and multivariate statistics. RESULTS The mean and median follow-up for all responders was 3.0 and 2.4 years. Pad-free continence at 12 months was 89%. A subset of 174 men reported preoperative and long-term responses; average follow-up was 5.8 years (range 4.0–10.3 years). AUAss for all men declined from baseline to 5 years by 3.7 (8.6 to 4.8) whereas QOL/Bother scores decreased by 0.5 (1.7 to 1.2) (all P < .05). Men with baseline mild LUTS remained clinically unchanged with long-term AUAss. Individuals with moderate and severe preoperative LUTS had marked improvements in AUA and QOL scores (all P ≤ .05). CONCLUSION Men with mild LUTS have short-term increases in AUAss but most return to baseline and are stable at 5 years. Benefits were found for men with preoperative moderate and severe LUTS in that 63% had significant QOL improvements and 68% reduced their AUAss to mild LUTS, persisting years after RARP. This study suggests that certain patients with preoperative urinary symptoms and bother may experience improvements in LUTS and associated QOL after RARP.

show abstract

“…To our knowledge, limited studies have evaluated UF after radical prostatectomy (RP) . Previously, we reported a doubling of PFR and a >50% reduction in PVR after open and robot‐assisted radical prostatectomy (RARP), both of which were stable with long‐term follow‐up across all age groups . The aim of the present study was primarily to evaluate whether there were significant improvements in PFR from baseline after RARP in men at risk of BOO, similar to those in men without BOO, and whether the improvements persist over long‐term follow up .…”

Section: Introductionmentioning

confidence: 91%

“…[5][6][7][8] Previously, we reported a doubling of PFR and a >50% reduction in PVR after open and robot-assisted radical prostatectomy (RARP), both of which were stable with long-term follow-up across all age groups. 9,10 The aim of the present study was primarily to evaluate whether there were significant improvements in PFR from baseline after RARP in men at risk of BOO, similar to those in men without BOO, and whether the improvements persist over long-term follow up. 10 Finally, because several reports have found an association between BOO and nerve growth factor (NGF), [11][12][13] we explored whether this relationship resulted in a more aggressive prostate cancer.…”

Section: Introductionmentioning

confidence: 99%

Diminished long‐term recovery of peak flow rate (PFR) after robotic prostatectomy in men with baseline PFR <10 mL/s and incidental association with high‐risk prostate cancer

Gordon

Skarecky

Babaian

et al. 2017

LUTS

Self Cite

View full text Add to dashboard Cite

show abstract

Analysis of Improved Urinary Peak Flow Rates After Robot-Assisted Radical Prostatectomy

Cited by 8 publications

References 23 publications

The Effect of the Vesical Adaptation Response to Diuresis on Lower Urinary Tract Symptoms after Robot-Assisted Laparoscopic Radical Prostatectomy: A Pilot Proof of Concept Study

The Effect of the Vesical Adaptation Response to Diuresis on Lower Urinary Tract Symptoms after Robot-Assisted Laparoscopic Radical Prostatectomy: A Pilot Proof of Concept Study

Quantification of Long-term Stability and Specific Relief of Lower Urinary Tract Symptoms (LUTS) After Robot-assisted Radical Prostatectomy

Diminished long‐term recovery of peak flow rate (PFR) after robotic prostatectomy in men with baseline PFR <10 mL/s and incidental association with high‐risk prostate cancer

Contact Info

Product

Resources

About