Long-term transition of urinary status after robot-assisted radical prostatectomy

To clarify and statistically analyze the long-term transition of urinary condition and quality of life (QOL) after robot-assisted radical prostatectomy (RARP) using some self-report questionnaires. From May 2017 to June 2021, 243 patients who underwent RARP for prostate cancer at Chiba Tokushukai Hospital were investigated retrospectively. The urinary status was observed for 5 years after surgery using the Core Lower Urinary Tract Symptom Score (CLSS), International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS), and International Continence Control Questionnaire-Short Form (ICIQ-SF). We used storage (IPSS-S) and voiding (IPSS-V) items separately for analysis. IPSS-S included "frequency", "urgency", and "nocturia", and IPSS-V included "incomplete emptying", "intermittency", "weak stream", and "straining". The association between the results of the questionnaire and postoperative urinary continence and QOL was examined by statistical analysis. Median values of follow-up duration were 65.5 months. Items in almost all questionnaires showed the worst points 1 month after surgery and recovered thereafter. All items showed recovery to the baseline level except for "urgency incontinence" and "stress incontinence". Preoperative IPSS-S > 7 was significantly associated with "pad-free" and "1 pad per day" status in multivariate analysis (Hazard ratio = 0.50 and 0.60, P < 0.01 and < 0.01, respectively). Urinary problems other than urinary incontinence can be restored to the baseline level after RARP. QOL differed between patients who showed a "pad-free" status and "1 pad per day" status. Additionally, preoperative IPSS-S was suggested to be a predictor of both "pad-free" status and "1 pad per day" status after surgery.