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Choi, Im, Kim, Kim, Kwon, and Ryu: Lower Urinary Tract Symptoms after Radical Retropubic Prostatectomy: Preliminary Study
Original Article
Korean Journal of Urology

Korean Journal of Urology 2008; 49(8): 715-719.

Published online: 31 August 2008

DOI: https://doi.org/10.4111/kju.2008.49.8.715

Lower Urinary Tract Symptoms after Radical Retropubic Prostatectomy: Preliminary Study

Hyang Sik Choi, Chang Min Im, Sun Ouck Kim, Myung Ki Kim1, Dong Deuk Kwon, Soo Bang Ryu

Department of Urology, Chonnam National University Medical School, Gwangju, Korea.

1Department of Urology, Chonbuk National University Medical School, Jeonju, Korea.

sbryu@chonnam.ac.kr

Received 9 May 2008       Accepted 17 June 2008

Copyright © 2008 The Korean Urological Association

Abstract

Purpose

The primary objective of this study was to evaluate the impact of radical retropubic prostatectomy (RRP) on lower urinary tract symptoms (LUTS) in patients with clinically localized prostate cancer.

Materials and Methods

Between 2000 and 2006, 82 men with clinically localized prostate cancer underwent RRP. The International Prostate Symptom Score (IPSS) and the IPSS quality of life (QoL) score, and uroflowmetry were administered both prior to and 1 year after RRP.

Results

The overall mean total IPSS, maximal flow rate, and postvoid residual volume did not change over time after RRP. Prior to and after RRP, the mean maximal flow rate and residual urine changed from 17.6ml/sec to 17.9ml/sec (p=0.566) and 16.9ml to 15.8ml (p=0.777), respectively. Total IPSS also changed after RRP, from 12.8 to 12.5 (p=0.731). The reduction of the IPSS was more prominent in patients with severe symptoms (IPSS≥20), whereas in those with moderate symptoms (8≤IPSS<20), the score did not change significantly after RRP. Furthermore, in those patients with no or mild symptoms (IPSS<8), the score increased after RRP.

Conclusions

RRP was not shown to improve uroflowmetric parameters, including maximal flow rate, postvoid residual urine, and IPSS, in cases of moderate LUTS. However, RRP may exert a beneficial effect in those patients with severe LUTS, and may also have adverse effects on some individuals with no or mild symptoms. We believe that these results might be utilized when counseling patients about treatment options for localized prostate cancer.

Keywords: Prostate cancer, Radical prostatectomy, Lower urinary tract symptoms

Figures and Tables

Table 1
Baseline characteristics of patients
kju-49-715-i001

PSA: prostate-specific antigen, *: prostate volume was calculated from transrectal ultrasound data using the ellipse fomula

Table 2
Comparison of uroflowmetry and IPSS prior to and after surgery
kju-49-715-i002

IPSS: International Prostate Symptom Score, RRP: radical retropubic prostatectomy

Table 3
Comparison of IPSS prior to and after surgery
kju-49-715-i003

IPSS: International Prostate Symptom Score, RRP: radical retropubic prostatectomy, *: statistically insignificant among the groups of mild, moderate, and severe IPSS

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