Atherosclerosis as a predictor of transient exacerbation of overactive bladder symptoms after robot‐assisted laparoscopic radical prostatectomy

Abstract

Objectives To assess whether atherosclerosis is involved in the development of overactive bladder and the function of lower urinary tract after robot‐assisted radical prostatectomy. Methods The present cohort consisted of 80 consecutive participants. The preoperative cardio‐ankle vascular index was used to evaluate the presence of atherosclerosis. The present cohort was split into two groups, the atherosclerotic group, whose cardio‐ankle vascular index was ≥9.0, and the control group, whose index was <9.0. The overactive bladder symptom score and lower urinary tract function were compared for 12 months after surgery. Results The total score of the questionnaire was significantly higher at 6 and 9 months after surgery in the atherosclerosis group (P = 0.04, P = 0.03, respectively). Both the urgency and urgency incontinence subscores of the questionnaire showed a parallel tendency to that of the total score after surgery. At 3 months after surgery, there was a significant increase in the prevalence of de novo overactive bladder in the atherosclerosis group (P = 0.04). At 9 and 12 months after surgery, there was a significant decrease of voided volume in the atherosclerotic group (P < 0.01, P = 0.04, respectively). Conclusions Atherosclerosis delays the improvement in both overactive bladder symptoms and storage function postoperatively, and it is involved in the transient increase in the prevalence of de novo overactive bladder. Atherosclerosis might be a predictor of the development of overactive bladder after robot‐assisted radical prostatectomy.

Editorial Comment from Dr Haga et al. to Minimal residual membranous urethral length and membranous urethral length predict poor recovery from incontinence after robot‐assisted radical prostatectomy and after open radical prostatectomy

“…We also demonstrated that urinary pooling inside the urethra evaluated by postoperative MRI might induce urgency 4 . In addition, patients with arteriosclerosis reportedly have persistence of OAB symptoms after RARP, and de novo OAB reportedly occurs to a greater extent in patients with arteriosclerosis than those without it 5 . Consequently, there is concern regarding the association between the mRUL and OAB symptoms, and additional clarification of this association is awaited.…”

Editorial Comment to Importance of considering interest in sex when evaluating satisfaction after robot‐assisted radical prostatectomy

“…Therefore, many papers regarding PRO after RARP have already been published. [1][2][3][4] In the present study, Kohada et al divided patients who underwent RARP into a high-interest in sex group and a lowinterest in sex group on the basis of attempts for penile rehabilitation. 5 The authors evaluated urinary function, urinary trouble, sexual function, and sexual trouble using the expanded prostate cancer index composite questionnaire.…”

“…Thus, patient reported outcomes (PRO) concerning their health‐related QOL are considered as important as screening for the recurrence of prostate cancer. Therefore, many papers regarding PRO after RARP have already been published 1–4 …”

Usefulness of a novel classification based on perioperative changes of membranous urethral length using hierarchical cluster analysis of urinary incontinence and overactive bladder symptoms after robot‐assisted radical prostatectomy: A prospective observational study

“…Even in the era of robotic surgery, there is still a constant percentage of patients with urinary incontinence (UI) and overactive bladder (OAB) symptoms after radical prostatectomy (RP) . Several studies investigated the associations between UI or OAB symptoms after RP and preoperative or postoperative membranous urethral length (MUL) .…”

“…Even in the era of robotic surgery, there is still a constant percentage of patients with urinary incontinence (UI) and overactive bladder (OAB) symptoms after radical prostatectomy (RP). [1][2][3][4] Several studies investigated the associations between UI or OAB symptoms after RP and preoperative or postoperative membranous urethral length (MUL). [5][6][7][8][9][10] These previous studies independently investigated only the associations between UI or OAB symptoms and preoperative or postoperative MUL.…”