Long-term urodynamic findings following radical prostatectomy and salvage radiotherapy

Abstract

Objective: Lower urinary tract symptoms (LUTS) are common following radical prostatectomy (RP) or intended curative radiotherapy in prostate cancer patients. One-quarter of those treated with RP experience biochemical failure and are subsequently offered salvage radiotherapy (SRT) to the prostatic bed. The aim of this study was to elucidate long-term LUTS after surgery and SRT.

Materials and methods: Urodynamic parameters from 16 patients treated with RP and subsequent SRT in the period 2000–2010 were evaluated with uroflowmetry, filling cystometry, pressure–flow and urethral pressure profile (UPP). In conjunction with the urodynamic examination, all patients completed the Danish Prostatic Symptom Score (DAN-PSS) questionnaire, which evaluates the grade of LUTS.

Results: Median time from SRT to urodynamic examination was 7.7 years (range 5.8–10.0 years). The following urodynamic parameters were affected: bladder volume at maximal cystometric capacity, bladder compliance, bladder function, bladder outlet obstruction and UPP. The total DAN-PSS index combining all symptoms and their corresponding impact on patients was mild in six patients (≤ 7 points), moderate in seven patients (8–19 points) and severe in three patients (≥ 20 points).

Conclusions: This urodynamic study is one of the first to evaluate long-term urodynamic characteristics in patients treated with SRT. Several urodynamic parameters were affected. This indicates that SRT primarily affects bladder compliance, maximal cystometric capacity and bladder outlet obstruction. LUTS were proven to be strongly related to urodynamic parameters.

Keywords:

• Late morbidity
• lower urinary tract symptoms
• prostatectomy
• prostatic neoplasms
• radiotherapy
• urodynamics

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was funded by the A.P. Møller Foundation. The sponsors had no role in any part of the study, including study design, data collection, data interpretation or writing of the manuscript.