Voiding Dysfunction after Radical Retropubic Prostatectomy: More than External Urethral Sphincter Deficiency

Porena, Massimo; Mearini, Ettore; Mearini, Luigi; Vianello, A.; Giannantoni, Antonella

doi:10.1016/j.eururo.2007.03.051

Cited by 143 publications

(105 citation statements)

References 44 publications

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Section: Urodynamic Testing Of Male Patients With Symptoms Of Urinarymentioning

confidence: 99%

“…6 There exists evidence, however, that sphincter incompetence can occur in conjunction with detrusor overactivity (DO), and also that DO with adequate sphincter function, low compliance, and urethral stricture are prevalent as the cause for UI or other LUT symptoms or dysfunction after radical prostatectomy. 7,8 The ICI-CDT recommends to perform complete UDS including cystometry and pressure flow analysis and PVR in patients with persisting incontinence or other LUT dysfunction following radical prostatectomy.Retrospective studies have shown that UDS cannot predict (S)UI or DO after surgical treatment for benign prostatic obstruction (BPO). 9 Studies have shown that UDS identifies the etiology of LUT dysfunction in these patients; however, the predictive value toward the effects of subsequent (re-treatment) treatment is unknown.…”

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confidence: 99%

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Executive summary: The International Consultation on Incontinence 2008—committee on: “Dynamic Testing”; for urinary or fecal incontinence. Part 2: Urodynamic Testing in male patients with symptoms of urinary incontinence, in patients with relevant neurological abnormalities, and in children and in frail elderly with symptoms of urinary incontinence

Szabo

Capewell

Gajewski

et al. 2009

Neurourology and Urodynamics

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Aims:The members of 'The International Consultation on Incontinence 2008 (Paris) Committee on Dynamic Testing' provide an executive summary of the chapter 'Dynamic Testing' that discusses (urodynamic) testing methods for patients with signs and or symptoms of urinary incontinence. Testing of patients with signs and or symptoms of fecal incontinence is also discussed. Methods: Evidence based and consensus committee report. Results: The chapter 'Dynamic Testing' is a continuation of previous Consultation reports added with a new systematic literature search and expert discussion. Conclusions, based on the published evidence and recommendations, based on the integration of evidence with expert experience and discussion are provided separately, for transparency. Conclusion: This second part of a series of three articles summarizes the committee's recommendations about: 'Urodynamic testing of male patients with symptoms of incontinence, of patients with relevant neurological abnormalities, testing of children and of frail elderly with symptoms of incontinence' and includes only the most recent and relevant literature references. Neurourol. Urodynam. 29:146-152, 2010. ß 2009 Wiley-Liss, Inc.Key words: consensus committee; incontinence (children); incontinence (frail elderly); incontinence (male); incontinence (neurologic); urodynamics INTRODUCTIONSubsequent to the first two reports of the International Consultation on Incontinence (ICI) 1,2 the chapter ''Urodynamic Testing'' was renamed ''Dynamic Testing'' in the third and fourth reports because of the additional inclusion of recommendations on the (diagnostic) management of fecal incontinence. 3 We (members of ''The ICI 2008 Committee on Dynamic Testing'': ICI-CDT) provide an executive summary of the chapter ''Dynamic Testing'' in the fourth ICI-report on incontinence. 4 The ICI-report, with the ICI-CDT chapter discussed here, has the intention to provide recommendations on the basis of the most reliable evidence for the current state of assessment of the patient with urinary or fecal incontinence. To this aim, dedicated and systematic literature searches were performed on the basis of keywords and on the basis of articles related to references in the previous ICI-reports. Throughout the chapters' text ''conclusion(s)'': solely and entirely based on the published scientific evidence, and ''recommendation(s)'' are highlighted. The ''recommendations'' are the integration of scientific evidence with the expert group consensus, together with the discussion with the attendees during the ICI meeting. Conclusions are separated from recommendations to produce maximum transparency about the ''evidence base'' of the recommendations. Likewise obtained ''topics(s) for research'' are also highlighted in the text of the ICI-report. In this executive summary, we discuss the chapter ''Dynamic Testing'' from the ICI-report in three parts: The innovations in urodynamic techniques ''in general,'' the test characteristics and normal values of urodynamic studies (UDS) as well as the asse...

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Section: Urodynamic Testing Of Male Patients With Symptoms Of Urinarymentioning

confidence: 99%

mentioning

confidence: 99%

Executive summary: The International Consultation on Incontinence 2008—committee on: “Dynamic Testing”; for urinary or fecal incontinence. Part 2: Urodynamic Testing in male patients with symptoms of urinary incontinence, in patients with relevant neurological abnormalities, and in children and in frail elderly with symptoms of urinary incontinence

Szabo

Capewell

Gajewski

et al. 2009

Neurourology and Urodynamics

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“…As divulged by a recent review of the literature, other factors such as detrusor overactivity, reduced bladder capacity, and impaired detrusor contractility can be pivotal for developing bladder dysfunction after prostatectomy [8]. Moreover, de novo detrusor instability after prostatectomy can lead to overactive bladder (OAB) symptoms, which may be detectable by urodynamic evaluation [9].…”

Section: Introductionmentioning

confidence: 99%

Monocyte Chemotactic Protein-1 (MCP-1) as a Predictor of Prolonged Urinary Incontinence After Radical Prostatectomy

Liss¹,

Ahlering

Morales

et al. 2016

TOUNJ

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Objectives:To investigate monocyte chemotactic protein-1 (MCP-1) as a novel urinary biomarker to predict prolonged post prostatectomy incontinence. Methods:Men submitted urine samples prior to robotic radical prostatectomy. MCP-1 values were derived using an ELISA test. Pad usage at 7, 30, and 60 days were documented by patient post cards mailed when zero pads was reached. The primary outcome was defined as no incontinence pad usage at 30 days at prostatectomy. Results:After exclusions, 76 patients were included in analyses. Continence was reached by 29% (22/76), 56% (42/76), and (75/76) 98% at 7, 30, and 60 days, respectively. The average MCP-1 (p=0.258) was not different between the continent and incontinent groups. Highest quartile of MCP-1 (MCP > 166 pg/mL) and normalized MCP-1 (MCP-1/TV >0.53) noted a significant delay in continence at 30 days (p=0.050 and p=0.003). Only 26% (5/19) in the highest MCP1/TV quartile were continent, whereas 65% (37/57) of men in the 3 lower quartiles reached zero pad continence (p=0.003). In a logistic regression model the highest quartile of MCP1/TV had a significant chance of being incontinent at 30 days (OR 0.22; 95% CI 0.058-0.80; p=0.022). Conclusion:MCP-1/TV is a urinary biomarker that may predict prolonged urinary incontinence after radical prostatectomy.

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“…Die genaue Ätiologie der postoperativen Harninkontinenz ist bisher noch nicht vollständig geklärt. Postuliert werden Verletzungen des Sphinkters oder der nervalen Strukturen und Blasendysfunktionen [17]. Auch spielen physiologische Alterungsprozesse eine große Rolle.…”

Section: Introductionunclassified

Prostatastanzbiopsien

Müller

Borrusch

Knop

et al. 2011

Urologe

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The aim of the study was to evaluate the best anesthesia for transrectal prostate biopsy, the complications after biopsy, and the influence of the biopsy on the clinical outcome after radical prostatectomy. The analysis included 1,383 patients after radical prostatectomy. With respect to compliance the biopsy should be performed under anesthesia. The most efficient procedure for pain reduction is analgosedation. Periprostatic local anesthetic in combination with the application of a lidocaine-containing jelly is in alternative use. Antibiotic prophylaxis should be given in consideration of possible antibiotic resistance due to recently administered antibiotic therapy. The percentage of R1 resection is higher if only one prostate biopsy can detect the carcinoma and leads immediately to radical prostatectomy. When several biopsies are necessary to detect the carcinoma the percentage of R1 resection is lower. Repeated prostate biopsies have no effect on the patients' outcome after radical prostatectomy. The best time for radical prostatectomy in relation to urinary incontinence is 8 weeks after prostate biopsy.

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Voiding Dysfunction after Radical Retropubic Prostatectomy: More than External Urethral Sphincter Deficiency

Cited by 143 publications

References 44 publications

Monocyte Chemotactic Protein-1 (MCP-1) as a Predictor of Prolonged Urinary Incontinence After Radical Prostatectomy

Prostatastanzbiopsien

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