De novo urinary storage symptoms are common after radical prostatectomy: Incidence, natural history and predictors Journal Article

Authors: Kan, K. M.; Tin, A. L.; Stearns, G. L.; Eastham, J. A.; Sjoberg, D. D.; Sandhu, J. S.
Article Title: De novo urinary storage symptoms are common after radical prostatectomy: Incidence, natural history and predictors
Abstract: Purpose:After radical prostatectomy (RP), clinical complaints of new onset storage symptoms may be related to anastomotic strictures or may accommodate for stress urinary incontinence; however, a subgroup of men will experience de novo storage symptoms in the absence of stricture or stress urinary incontinence. As therapies for overactive bladder have improved, we sought to assess the prevalence, natural history and risk factors of de novo storage dysfunction in continent men.Materials and Methods:We retrospectively analyzed urinary symptom questionnaires completed by patients who were continent prior to RP and did not have postoperative anastomotic strictures at our institution from 2002 to 2019. De novo storage dysfunction, assessed as new onset or worsening urgency or frequency, was assessed at 6, 12, 18 and 24 months after RP, and association between it and patient and preoperative factors was determined.Results:A total of 2,619 patients were included in the final analysis. An initial 34% of patients reported de novo storage symptoms at 6 months, which decreased to 26% at later followup. We found evidence that minimally invasive surgery and nonWhite race were associated with reporting worsening symptoms. The association between postoperative hematoma and worsening symptoms was less conclusive but was of clear clinical relevance (OR 3.15; 95% CI 1.04, 9.54; p=0.042).Conclusions:A significant number of RP patients experience de novo storage symptoms. Patients who underwent minimally invasive surgery are at higher risk. At-risk patients should be counseled on the incidence of de novo storage symptoms and offered early treatment per overactive bladder guidelines. © 2022 Lippincott Williams and Wilkins. All rights reserved.
Keywords: prostatectomy; lower urinary tract symptoms; urinary bladder, overactive
Journal Title: Journal of Urology
Volume: 207
Issue: 3
ISSN: 0022-5347
Publisher: Elsevier Science, Inc.  
Date Published: 2022-03-01
Start Page: 601
End Page: 607; discussion 608
Language: English
DOI: 10.1097/ju.0000000000002312
PUBMED: 34694923
PROVIDER: scopus
PMCID: PMC10031753
Notes: Article -- Export Date: 1 March 2022 -- Source: Scopus
Citation Impact
MSK Authors
  1. Jaspreet Sandhu
    125 Sandhu
  2. Daniel D. Sjoberg
    215 Sjoberg
  3. James Eastham
    506 Eastham
  4. Amy Lam Ling Tin
    77 Tin