Uroflow stop test with electromyography: a novel index of urinary continence recovery after RARP

Boni, Andrea; Cochetti, Giovanni; Zingaro, Michele Del; Paladini, Alessio; Turco, Morena; Vermandois, J.A. Rossi De; Mearini, Ettore

doi:10.1007/s11255-019-02107-3

Cited by 15 publications

(12 citation statements)

References 33 publications

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“…Among others, these apply to detrusor underactivity, detrusor overactivity, bladder outlet obstruction, and reduced bladder compliance. Although novel tools are evolving [ 13 ], the most precise method to evaluate them all is the urodynamic pressure-flow study (UDS). Therefore, the aim of our systematic review is to evaluate the impact of radical prostatectomy on bladder function, with special attention towards detrusor underactivity investigated with the means of urodynamic evaluation.…”

Section: Introductionmentioning

confidence: 99%

De Novo Detrusor Underactivity and Other Urodynamic Findings after Radical Prostatectomy: A Systematic Review

et al. 2022

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Background and objectives: The aim of this systematic review is to evaluate the impact of radical prostatectomy (RP) on bladder function, with special attention towards detrusor underactivity investigated with the means of urodynamic evaluation. Materials and Methods: The review was performed in accordance with the PRISMA statement and was registered in the PROSPERO (ID#: CRD42020223480). The studied population was limited to men with prostate cancer who underwent urodynamic study prior to and after radical prostatectomy. Eight hundred twenty-seven studies were screened, with twenty-five finally included. A qualitative analysis was performed. Rates of detrusor underactivity (DU) before surgery were reported in eight studies and ranged from 1.6% to 75% (median of 40.8%). DU occurred de novo after RP in 9.1% to 37% of patients (median of 29.1%). On the other hand, preexisting DU resolved in 7% to 35.5% of affected men. Detrusor overactivity (DO) was the most frequently reported outcome, being assessed in 23 studies. The rate of DO preoperatively was from 5% to 76% (median of 25%). De novo was reported in 2.3–54.4% of patients (median of 15%) and resolved after RP in 19.6% to 87.5% (median of 33%) of affected patients. Baseline rates of bladder outlet obstruction (BOO) varied between studies from 19% to 59.3%, with a median of 27.8%. The most pronounced change after surgery was the resolution of BOO in 88% to 93.8% (median of 92%) of affected patients. Results: Rates of de novo impaired bladder compliance (IBC) varied from 3.2% to 41.3% (median of 13.3%), whereas the resolution of IBC was reported with rates ranging from 0% to 47% (median of 4.8%). Conclusions: BOO, DO, and DU are frequently diagnosed in men scheduled for RP. BOO is improved after RP in most patients; however, there is still a substantial rate of patients with de novo DU as well as DO which may impair functional outcomes and quality of life.

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Section: Introductionmentioning

confidence: 99%

De Novo Detrusor Underactivity and Other Urodynamic Findings after Radical Prostatectomy: A Systematic Review

et al. 2022

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“…However, we believe that the results are still relevant, especially in those who suffered badly from the worsening of LUTS after vaccination, in whom the AEs were notably painful. Other non-invasive and easily performed tools, such as the uroflow stop test [ 33 ], to assess LUTS may be considered in the future studies, which may provide us with more objective results. Second, selection bias remains in our study because the questionnaire was based on the social network, which may affect the selection of patients with side effects related to the vaccine.…”

Section: Discussionmentioning

confidence: 99%

Does COVID-19 Vaccination Cause Storage Lower Urinary Tract Symptoms?

Chen

Liang

et al. 2022

JCM

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We investigated the storage lower urinary tract symptoms (LUTS) before and after the first dose of coronavirus disease 2019 (COVID-19) vaccine and the association between pre-vaccinated overactive bladder (OAB) and the worsening of storage LUTS following COVID-19 vaccination. This cross-sectional study in a third-level hospital in Taiwan used the validated pre- and post-vaccinated Overactive Bladder Symptom Score (OABSS). Diagnosis of OAB was made using pre-vaccinated OABSS. The deterioration of storage LUTS was assessed as the increased score of OABSS following vaccination. Of 889 subjects, up to 13.4% experienced worsened storage LUTS after vaccination. OAB was significantly associated with an increased risk of worsening urinary urgency (p = 0.030), frequency (p = 0.027), and seeking medical assistance due to urinary adverse events (p < 0.001) after vaccination. The OAB group faced significantly greater changes in OABSS-urgency (p = 0.003), OABSS-frequency (p = 0.025), and total OABSS (p = 0.014) after vaccination compared to those observed in the non-OAB group. Multivariate regression revealed that pre-vaccinated OAB (p = 0.003) was a risk for the deterioration of storage LUTS. In conclusion, storage LUTS may deteriorate after vaccination. OAB was significantly associated with higher risk and greater changes in worsening storage LUTS. Storage LUTS should be closely monitored after COVID-19 vaccination, especially in those OAB patients.

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“…It should also be emphasized that the reported results may be affected by the preoperative clinical characteristics of the patients, the surgeon's experience, the surgical technique, and the methods used to collect and report data. In fact, as with the laparotomic and laparoscopic approach, age, comorbidities, obesity, and the presence of lower urinary tract symptoms are also factors associated with a worse functional result in terms of urinary continence for the robotic approach [8]. On the other hand, in a randomized phase III study, in which the functional results of the three approaches were compared with a follow up of 24 months, Coughlin et al found no significant difference between the three different techniques [19].…”

Section: Why Robotics In Radical Prostatectomy?mentioning

confidence: 99%

“…Urinary incontinence and erectile dysfunction are the main adverse effects of RP and are reported up to 31% and 38% at 12 months, respectively [8,9]. To improve functional outcomes in the literature, many different nerve-sparing techniques have been described, but the best one is not yet established.…”

Section: Introductionmentioning

confidence: 99%

New Evolution of Robotic Radical Prostatectomy: A Single Center Experience with PERUSIA Technique

et al. 2021

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Radical prostatectomy (RP) is the standard surgical treatment of organ-confined prostate cancer in patients with a life expectancy of at least 10 years. In a recent prospective study, we described the PERUSIA (Posterior, Extraperitoneal, Robotic, Under Santorini, Intrafascial, Anterograde) technique, which is an extraperitoneal full nerve sparing robotic RP, showing its feasibility and safety. The aim of this retrospective study was to evaluate the peri-operative, oncologic, and functional outcomes of the PERUSIA technique. We retrospectively analyzed the data of 454 robotic-assisted radical prostatectomies (RARP) performed using the PERUSIA technique from January 2012 to October 2019. We evaluated perioperative outcomes (operative time, estimated blood loss, catheterization time, complication rate, length of stay), oncological (positive surgical margins and biochemical recurrence), and functional outcomes in terms of urinary continence and sexual potency. The overall complication rate was 16%, positive surgical margins were 8.1%, and biochemical recurrence occurred in 8.6% at median follow-up of 47 months. Urinary continence was achieved in 69% of cases the day after the removal of the catheter, in 92% at 3 months, and in 97% at 12 months after surgery. The average rate of sexual potency was 72% and 82% respectively 3 and 12 months after surgery. Our findings show that the PERUSIA technique is a safe extraperitoneal approach to perform a full nerve sparing technique providing exciting functional outcomes.

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Uroflow stop test with electromyography: a novel index of urinary continence recovery after RARP

Cited by 15 publications

References 33 publications

De Novo Detrusor Underactivity and Other Urodynamic Findings after Radical Prostatectomy: A Systematic Review

De Novo Detrusor Underactivity and Other Urodynamic Findings after Radical Prostatectomy: A Systematic Review

Does COVID-19 Vaccination Cause Storage Lower Urinary Tract Symptoms?

New Evolution of Robotic Radical Prostatectomy: A Single Center Experience with PERUSIA Technique

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