Minimally invasive Radical prostatectomy tied to De Novo storage symptoms
A new study shows that de novo storage symptoms occur in a significant number of Radical Prostatectomy (RP) patients. Patients who have had minimally invasive surgery (MIS) are more vulnerable. Clinical complaints of new onset storage symptoms after RP may be due to anastomotic strictures or as an accommodation for stress urinary incontinence; however, a subset of men will experience de novo storage symptoms in the absence of stricture or stress urinary incontinence.
The following study was conducted by Kathleen M. Kan and team in order to assess the prevalence, natural history, and risk factors of de novo storage dysfunction in men from the continent. The findings of this study were published in The Journal Of Urology on 25th October, 2021.
From 2002 to 2019, researchers at our institution examined urinary symptom questionnaires completed by patients who were continent prior to RP and did not have post-operative anastomotic strictures. At 6, 12, 18, and 24 months after RP, de novo storage dysfunction was assessed as new onset or worsening urgency or frequency, and the relationship between it and patient and preoperative factors was determined.
The final analysis included a total of 2619 patients. At 6 months, 34% of patients reported de novo storage symptoms, which decreased to 26% at the 6-month follow-up. It was discovered that reporting worsening symptoms was associated with minimally invasive surgery and nonwhite race. The link between post-operative hematoma and worsening symptoms was less conclusive, but it was clinically significant.
Finally, at-risk patients should be counselled on the likelihood of de novo storage symptoms and offered early treatment in accordance with OAB guidelines.
Reference:
Kan, K. M., Tin, A. L., Stearns, G. L., Eastham, J. A., Sjoberg, D. D., & Sandhu, J. S. (2021). De Novo Urinary Storage Symptoms are Common after Radical Prostatectomy: Incidence, Natural History and Predictors. In Journal of Urology. Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.1097/ju.0000000000002312
