Postoperative urinary incontinence exacerbates nocturia‐specific quality of life after robot‐assisted radical prostatectomy

Abstract

Although the number of nocturia episodes was not significantly different between the continent and incontinent patients after surgery, the Nocturia Quality of Life questionnaire score was significantly worse in incontinent patients. In these patients, other than the number of nocturia episodes, psychological stress might worsen the Nocturia Quality of Life questionnaire score. Therefore, prevention of post-prostatectomy incontinence might be important to avoid aggravating the Nocturia Quality of Life questionnaire score.

Editorial Comment from Dr Kadono to Postoperative urinary incontinence exacerbates nocturia‐specific quality of life after robot‐assisted radical prostatectomy

“…According to the results of multivariate analysis, the aggravating factors of the Japanese version of the nocturia QOL score revealed nocturnal frequency and urinary incontinence . Nocturnal frequency was the same in the continence and incontinence groups; however, the Japanese version of the nocturia QOL score was worse in the incontinence group, which might be because of psychological stress . Mean nocturnal frequency before RP was almost the same at 1 year after RP; however, evaluation of each patient showed that nocturia of 20–30% patients improved, whereas that of the other 20–30% of patients worsened after RP …”

“…After RP, anatomical changes in the pelvis cause functional changes in the lower urinary tract. Furthermore, in regard to chronological changes in nocturnal frequencies, the nocturia worsened at 3 months after RP, and it returned to almost the same pre‐RP level at 1 year after RP . Subjective QOL was evaluated using a validated Japanese version of the nocturia QOL questionnaire, and objective urinary frequency and urine volume were evaluated using the 24‐h frequency–volume chart .…”

“…Furthermore, in regard to chronological changes in nocturnal frequencies, the nocturia worsened at 3 months after RP, and it returned to almost the same pre‐RP level at 1 year after RP . Subjective QOL was evaluated using a validated Japanese version of the nocturia QOL questionnaire, and objective urinary frequency and urine volume were evaluated using the 24‐h frequency–volume chart . Previously, detailed analysis of lower urinary functions using urodynamic evaluations before and 1 year after RP showed that the storage function after RP recovered to almost the same pre‐RP level, the voiding function after RP improved and the urethral sphincter function after RP worsened compared with the pre‐RP condition .…”

“…It is conceivable that abdominal pressure does not work during sleep because of low activities; therefore, the frequency of nocturia at 1 year after RP might not change compared with before RP, because the storage function at 1 year after RP recovered to the pre‐RP level even if urethral sphincter function worsened slightly . According to the results of multivariate analysis, the aggravating factors of the Japanese version of the nocturia QOL score revealed nocturnal frequency and urinary incontinence . Nocturnal frequency was the same in the continence and incontinence groups; however, the Japanese version of the nocturia QOL score was worse in the incontinence group, which might be because of psychological stress .…”

Editorial Comment from Dr Stranne and Psychotherapist Stranne to Postoperative urinary incontinence exacerbates nocturia‐specific quality of life after robot‐assisted radical prostatectomy

“…In the article by Haga et al ., the authors address the issue of nocturia‐specific quality of life (QoL), in relation to post robot‐assisted laparoscopic radical prostatectomy (RARP) incontinence . Nocturia, i.e.…”