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Longitudinal observational cohort study about detrusor underactivity as a risk factor for bladder neck contracture after retropubic radical prostatectomy: preliminary results

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Abstract

Objectives

To evaluate the association between preoperative detrusor underactivity (DU) and symptomatic bladder neck contracture (BNC) in patients undergoing radical retropubic prostatectomy (RRP), in order to identify a possible new risk factor in the etiopathogenic mechanisms of BNC after RRP.

Methods

A total of 100 prostate cancer patients underwent RRP after preoperative complete urodynamic examination. Detrusor contractility was evaluated by bladder contractility index (BCI), power at maximum flow (WF-Qmax), and maximum velocity of detrusorial contraction (MVDC). Follow-up included uroflowmetry with bladder post-voiding volume evaluation at 3 and 6 months after surgery and repeated urodynamic examination at 12 months. Statistical evaluation was performed using the Student’s t test (P < 0.01).

Results

The mean patient age was 65.6 ± 5.4 years, and pathological stage ranged from T2a to T2c. A total of 40 patients (40 %) presented normal detrusor contractility, 47 (47 %) mild DU, and 13 (13 %) severe DU. Detrusor overactivity (DO) was observed in 12 patients (12 %), small cystometric capacity in 10 (10 %), low compliance in 16 (16 %), DO plus DU (mild or severe) in 6 (6 %), and DO plus small cystometric capacity together with low compliance in 5 (5 %). Normal urodynamics were observed in 38 patients (38 %). Overall BNC incidence was 12. All patients with BNC presented preoperative DU; none presented DO or low bladder compliance. DU severity and BNC occurrence were significantly correlated (P < 0.01) for all 3 urodynamic parameters (BCI, WF-Qmax, and MVDC).

Conclusions

We identify DU as a possible novel risk factor for BNC formation after radical prostatectomy that may contribute to its development.

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Conflict of interest

The authors report no conflict of interests. The authors alone are responsible for the content and writing of the paper.

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Authors and Affiliations

  1. Department of Urology, University of Messina, Via Consolare Valeria, 98100, Messina, Italy

    Giuseppe Mucciardi, Alessandro Galì, Antonino Inferrera, Antonina Di Benedetto, Luciano Macchione & Carlo Magno

  2. Department of Economics, Business, Environmental Sciences and Quantitative Methods-Division of Mathematics and Statistics, University of Messina, Messina, Italy

    Massimo Mucciardi

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  1. Giuseppe Mucciardi
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  2. Alessandro Galì
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  3. Antonino Inferrera
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  4. Antonina Di Benedetto
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  5. Luciano Macchione
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  6. Massimo Mucciardi
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  7. Carlo Magno
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Correspondence to Carlo Magno.

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Mucciardi, G., Galì, A., Inferrera, A. et al. Longitudinal observational cohort study about detrusor underactivity as a risk factor for bladder neck contracture after retropubic radical prostatectomy: preliminary results. Int Urol Nephrol 45, 721–726 (2013). https://doi.org/10.1007/s11255-013-0426-y

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  • DOI: https://doi.org/10.1007/s11255-013-0426-y

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