Patterns of Benign Prostate Hyperplasia Based on Magnetic Resonance Imaging Are Correlated With Lower Urinary Tract Symptoms and Continence in Men Undergoing a Robot-assisted Radical Prostatectomy for Prostate Cancer

Grivas, Nikolaos; Roest, Rosanne van der; Tillier, Corinne; Schouten, Daan; Muilekom, Erik van; Schoots, Ivo G.; Poel, Henk van der; Heijmink, Stijn W. T. P. J.

doi:10.1016/j.urology.2017.05.047

Cited by 22 publications

(21 citation statements)

References 29 publications

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“…However, although age, pathological stage of prostate cancer, and nerve‐sparing status were evaluated among each cluster, there were no significant differences in these factors among the clusters. Third, although Grivas et al demonstrated that protrusion of the prostate into the bladder on preoperative MRI was associated with UI and LUTS after RP, such parameters associated with the prostate shape on preoperative MRI were not evaluated in the present study. Further cluster analyses in the next study would be needed to clarify the involvement of the prostate shape for the UI and LUTS after RARP.…”

Section: Discussionmentioning

confidence: 61%

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

Onoda

Haga

Kurimura

et al. 2019

Neurourology and Urodynamics

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Aims The aim of the present study was to construct a novel classification based on perioperative changes of membranous urethral length (MUL) using hierarchical cluster analysis to predict urinary incontinence (UI) and overactive bladder (OAB) symptoms after robot‐assisted radical prostatectomy (RARP). Methods A total of 299 patients who underwent RARP with complete pre and postoperative MUL data were included in the present study. Hierarchical cluster analysis was performed to identify the groups with similar perioperative MUL and prostate size. UI and OAB symptoms after RARP were evaluated in each cluster for 12 months after RARP. Results Four groups were identified by the cluster analysis of these factors: preservation of MUL type (cluster 1, n = 92); standard type (cluster 2, n = 137); large prostate type (cluster 3, n = 23); and loss of MUL type (cluster 4, n = 47). Although there was significantly more UI in clusters 3 and 4 than in clusters 1 and 2 up to 3 months after RARP, UI improvement was the most delayed in cluster 3. Improvement of OAB symptoms was also most delayed in cluster 3. Urinary quality of life (QOL) was significantly worse in cluster 4 than in clusters 1 and 2. Conclusions Cluster analysis successfully classified patients after RARP into four characteristic groups based on perioperative MUL. Recovery from UI and OAB symptoms and urinary QOL after RARP were significantly different among these groups. This classification based on cluster analysis might be useful to predict recovery from UI and OAB symptoms when following QOL after RARP.

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Section: Discussionmentioning

confidence: 61%

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

Onoda

Haga

Kurimura

et al. 2019

Neurourology and Urodynamics

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“…Therefore, the effect of IPP on preoperative urinary status also affects the urinary status after RARP. Additionally, as Grivas et al reported that IPP predicts the extent of bladder outlet obstruction seen in PFS, it is understandable that IPP affects both preoperative and post-RARP urinary states [6]. However, Grivas et al also reported that IPP was not a significant factor affecting the continence rate, although their study evaluated outcomes at only 6 and 12 months after RARP [6].…”

Section: Discussionmentioning

confidence: 99%

“…Patients with severe lower urinary tract symptoms (LUTS) showed improvement in their subjective symptoms after RARP [5]. Alternatively, reports have investigated the association between benign prostatic hyperplasia (BPH) patterns and early continence after RARP [6]. Currently, several markers have been identified as significant in the clinical progression of BPH.…”

Section: Introductionmentioning

confidence: 99%

Intravesical prostatic protrusion may affect early postoperative continence undergoing robot-assisted radical prostatectomy

et al. 2020

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Background In this study, we investigated the effect of preoperative prostate morphology, especially intravesical prostatic protrusion (IPP), on continence after robot-assisted radical prostatectomy (RARP). Methods Retrospective analysis was applied to patients who underwent RARP between October 2010 and July 2014. The following parameters were assessed in all patients: age, body mass index (BMI), prostate-specific antigen, magnetic resonance imaging and pressure-flow studies findings. The impact of preoperative and intraoperative factors on postoperative urinary incontinence (UI) was assessed using multivariate logistic regression analysis. To evaluate the effects of IPP, the patients were divided into groups according to the IPP length: Group 1, < 5 mm and Group 2, ≥ 5 mm. The International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score, Quality of Life index and the number of pads used were assessed. Results A total of 119 patients were eligible for this study. Multivariate analyses showed that IPP (odds ratio (OR) 1.14, 95% confidence interval (CI) 1.02–1.28, p < 0.05) and nerve-sparing (NS) (OR 0.23, 95% CI 0.18–0.61, p < 0.01) were significant factors related to UI in the first month after RARP. Twelve months after RARP, multivariate analyses revealed that only NS is a factor related to postoperative UI (OR 0.23, 95% CI 0.18–0.61, p < 0.01). The comparison of Groups 1 and 2 indicated significant differences in age (p < 0.01), prostate volume (p < 0.01), total IPSS and voiding symptom score (p < 0.05), compliance (p < 0.01), and detrusor pressure at maximum flow (p < 0.01). Group 1 had a higher continence rate (38.0%) than Group 2 (20.8%) in the first month after RARP (p < 0.05), but the difference was no longer significant from the third month after RARP. The total IPSS and voiding symptom scores were significantly different between the two groups before RARP, however, the significant difference disappeared from the first month after RARP. Conclusions The data suggest that IPP affects early postoperative UI. Although NS was strongly involved in UI in the early and later stages after RARP, IPP had no effect on UI in the later stages.

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“…Although cystoscopy will be less invasive than PFS, it might be more comfortable for patients to undergo recently progressing imaging modalities to assess prostate morphology such as three‐dimensional ultrasound or MRI. MRI‐based morphological classification of prostate and its association to LUTS have been reported in the field of radical prostatectomy . Kanao et al clearly showed the shape of prostate enlarged with middle lobe using three‐dimensional ultrasound which will be widespread in the urology field more because the system is applied for recently advancing MRI‐ultrasound fusion prostate biopsy.…”

Section: Discussionmentioning

confidence: 99%

Intravesical prostatic protrusion is not always the same shape: Evaluation by preoperative cystoscopy and outcome in HoLEP

Ito

Takashima

Akamatsu

et al. 2018

Neurourology and Urodynamics

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Patterns of Benign Prostate Hyperplasia Based on Magnetic Resonance Imaging Are Correlated With Lower Urinary Tract Symptoms and Continence in Men Undergoing a Robot-assisted Radical Prostatectomy for Prostate Cancer

Cited by 22 publications

References 29 publications

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

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

Intravesical prostatic protrusion may affect early postoperative continence undergoing robot-assisted radical prostatectomy

Intravesical prostatic protrusion is not always the same shape: Evaluation by preoperative cystoscopy and outcome in HoLEP

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