Urinary function and prostate cancer
6. Liao CH, Chung SD, Kuo HC. Diagnostic value of International Prostate Symptom Score voiding-to-storage subscore ratio in male lower urinary tract symptoms. Int. J. Clin. Pract. 2011; 65: 552–8. 7. Matsubara A, Yoneda T, Yasumoto H et al. Lower urinary tract symptoms after radical perineal prostatectomy. Jpn. J. Clin. Oncol. 2007; 37: 534–9. 8. Aboseif SR, Konety B, Schmidt RA, Goldfien SH, Tanagho EA, Narayan PA. Preoperative urodynamic evaluation: does it predict the degree of urinary continence after radical retropubic prostatectomy? Urol. Int. 1994; 53: 68–73. 9. Namiki S, Ishidoya S, Saito S et al. Natural history of voiding function after radical retropubic prostatectomy. Urology 2006; 68: 142–7. 10. Middelkoop HA, Smilde-van den Doel DA, Neven AK, Kamphuisen HA, Springer CP. Subjective sleep characteristics of 1,485 males and females aged 50–93: effects of sex and age, and factors related to self-evaluated quality of sleep. J. Gerontol. A Biol. Sci. Med. Sci. 1996; 51: M108–15. 11. Asplund R. Mortality in the elderly in relation to nocturnal micturition. BJU Int. 1999; 84: 297–301.
12. Porena M, Mearini E, Mearini L, Vianello A, Giannantoni A. Voiding dysfunction after radical retropubic prostatectomy: more than external urethral sphincter deficiency. Eur. Urol. 2007; 52: 38–45. 13. Schlegel PN, Walsh PC. Neuroanatomical approach to radical cystoprostatectomy with preservation of sexual function. J. Urol. 1987; 138: 1402–6. 14. Hollabaugh RS Jr, Dmochowski RR, Kneib TG, Steiner MS. Preservation of putative continence nerves during radical retropubic prostatectomy leads to more rapid return of urinary continence. Urology 1998; 51: 960–7. 15. Lepor H, Kaci L. The impact of open radical retropubic prostatectomy on continence and lower urinary tract symptoms: a prospective assessment using validated self-administered outcome instruments. J. Urol. 2004; 171: 1216–9. 16. Oelke M, Giuliano F, Mirone V, Xu L, Cox D, Viktrup L. Monotherapy with tadalafil or tamsulosin similarly improved lower urinary tract symptoms suggestive of benign prostatic hyperplasia in an international, randomised, parallel, placebo-controlled clinical trial. Eur. Urol. 2012; 61: 917–25.
Original Article: Editorial Comment Clinical Investigation Editorial Comment to International Prostate Symptom Score is a predictive factor of lower urinary tract symptoms after radical prostatectomy The majority of men who undergo radical prostatectomy (RP) are aged between 50 and 70 years. It has been shown that 44% of men with localized prostate cancer who present for RP have moderate to severe lower urinary tract symptoms (LUTS) that might be a result of benign prostatic hyperplasia (BPH).1 Evaluation of lower urinary tract function after RP is as important as evaluation of urinary incontinence after RP. In the present study, the authors reported that RP improved International Prostate Symptom Score (IPSS) and IPSS quality of life over a 24-month study period. The majority of patients reached an IPSS of ≤7. However, 17% of patients with clinically significant LUTS (IPSS >7) still had urinary disorders, despite their continence status. The following finding of paramount importance is noted in Table 2 of the article: baseline age, prostate volume and initial IPSS were independent factors related to alleviation of LUTS after RP.2 The time-course after RP represents the natural history of LUTS in the absence of the prostate. The fact that LUTS remained constant beyond 5 years after RP in men with or without baseline clinically insignificant LUTS (IPSS of ≤7) suggests that RP interferes with the natural history of BPH by removing the prostate, which is otherwise the primary contribution to LUTS progression in men.3 Although patients with localized prostate cancer now routinely live more than 10 years after diagnosis, this long period affords a greater opportunity for the development of additional comorbid conditions that might have a negative impact on quality of life.4 Thus, identifying patients at high risk for adverse urinary function outcomes is pivotal for medical decision-making. In the study, urinary function decreased immediately after surgery, followed by a variable recovery phase within the first 2 years. It is interesting to note that
© 2015 The Japanese Urological Association
5 after 2 years, another slight but statistically significant age-dependent decrease of LUTS was observed between 8 and 10 years. In individual preoperative and postoperative patient counseling, individual risk factors for urinary and/or sexual dysfunction should be identified.
Shunichi Namiki Ph.D.1,2 Department of Urology, Tohoku University Graduate School of Medicine and 2Department of Urology, Japan Community Health Care Organization Sendai Hospital, Sendai, Japan [email protected]
1
DOI: 10.1111/iju.12692
Conflict of interest None declared.
References 1. Arai Y, Egawa S, Tobisu K et al. Radical retropubic prostatectomy: Time trends, morbidity and mortality in Japan. BJU Int. 2000; 85: 287–94. 2. Bayoud Y, de la Taille A, Ouzzane A et al. International Prostate Symptom Score is a predictive factor of lower urinary tract symptoms after radical prostatectomy. Int. J. Urol. 2015; 22: 283–7. 3. Namiki S, Kaiho Y, Mitsuzuka K et al. Long-term quality of life after radical prostatectomy: 8-Year longitudinal study in Japan. Int. J. Urol. 2014; 21: 1220–6. 4. Taub DA, Wei JT. The economics of benign prostatic hyperplasia and lower urinary tract symptoms in the United States. Curr. Urol. Rep. 2006; 7: 272–81. 5. Prabhu V, Sivarajan G, Taksler GB, Laze J, Lepor H. Long-term Continence Outcomes in Men Undergoing Radical Prostatectomy for Clinically Localized Prostate Cancer. Eur. Urol. 2014; 65: 58–65.
287
Copyright of International Journal of Urology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
6. Liao CH, Chung SD, Kuo HC. Diagnostic value of International Prostate Symptom Score voiding-to-storage subscore ratio in male lower urinary tract symptoms. Int. J. Clin. Pract. 2011; 65: 552–8. 7. Matsubara A, Yoneda T, Yasumoto H et al. Lower urinary tract symptoms after radical perineal prostatectomy. Jpn. J. Clin. Oncol. 2007; 37: 534–9. 8. Aboseif SR, Konety B, Schmidt RA, Goldfien SH, Tanagho EA, Narayan PA. Preoperative urodynamic evaluation: does it predict the degree of urinary continence after radical retropubic prostatectomy? Urol. Int. 1994; 53: 68–73. 9. Namiki S, Ishidoya S, Saito S et al. Natural history of voiding function after radical retropubic prostatectomy. Urology 2006; 68: 142–7. 10. Middelkoop HA, Smilde-van den Doel DA, Neven AK, Kamphuisen HA, Springer CP. Subjective sleep characteristics of 1,485 males and females aged 50–93: effects of sex and age, and factors related to self-evaluated quality of sleep. J. Gerontol. A Biol. Sci. Med. Sci. 1996; 51: M108–15. 11. Asplund R. Mortality in the elderly in relation to nocturnal micturition. BJU Int. 1999; 84: 297–301.
12. Porena M, Mearini E, Mearini L, Vianello A, Giannantoni A. Voiding dysfunction after radical retropubic prostatectomy: more than external urethral sphincter deficiency. Eur. Urol. 2007; 52: 38–45. 13. Schlegel PN, Walsh PC. Neuroanatomical approach to radical cystoprostatectomy with preservation of sexual function. J. Urol. 1987; 138: 1402–6. 14. Hollabaugh RS Jr, Dmochowski RR, Kneib TG, Steiner MS. Preservation of putative continence nerves during radical retropubic prostatectomy leads to more rapid return of urinary continence. Urology 1998; 51: 960–7. 15. Lepor H, Kaci L. The impact of open radical retropubic prostatectomy on continence and lower urinary tract symptoms: a prospective assessment using validated self-administered outcome instruments. J. Urol. 2004; 171: 1216–9. 16. Oelke M, Giuliano F, Mirone V, Xu L, Cox D, Viktrup L. Monotherapy with tadalafil or tamsulosin similarly improved lower urinary tract symptoms suggestive of benign prostatic hyperplasia in an international, randomised, parallel, placebo-controlled clinical trial. Eur. Urol. 2012; 61: 917–25.
Original Article: Editorial Comment Clinical Investigation Editorial Comment to International Prostate Symptom Score is a predictive factor of lower urinary tract symptoms after radical prostatectomy The majority of men who undergo radical prostatectomy (RP) are aged between 50 and 70 years. It has been shown that 44% of men with localized prostate cancer who present for RP have moderate to severe lower urinary tract symptoms (LUTS) that might be a result of benign prostatic hyperplasia (BPH).1 Evaluation of lower urinary tract function after RP is as important as evaluation of urinary incontinence after RP. In the present study, the authors reported that RP improved International Prostate Symptom Score (IPSS) and IPSS quality of life over a 24-month study period. The majority of patients reached an IPSS of ≤7. However, 17% of patients with clinically significant LUTS (IPSS >7) still had urinary disorders, despite their continence status. The following finding of paramount importance is noted in Table 2 of the article: baseline age, prostate volume and initial IPSS were independent factors related to alleviation of LUTS after RP.2 The time-course after RP represents the natural history of LUTS in the absence of the prostate. The fact that LUTS remained constant beyond 5 years after RP in men with or without baseline clinically insignificant LUTS (IPSS of ≤7) suggests that RP interferes with the natural history of BPH by removing the prostate, which is otherwise the primary contribution to LUTS progression in men.3 Although patients with localized prostate cancer now routinely live more than 10 years after diagnosis, this long period affords a greater opportunity for the development of additional comorbid conditions that might have a negative impact on quality of life.4 Thus, identifying patients at high risk for adverse urinary function outcomes is pivotal for medical decision-making. In the study, urinary function decreased immediately after surgery, followed by a variable recovery phase within the first 2 years. It is interesting to note that
© 2015 The Japanese Urological Association
5 after 2 years, another slight but statistically significant age-dependent decrease of LUTS was observed between 8 and 10 years. In individual preoperative and postoperative patient counseling, individual risk factors for urinary and/or sexual dysfunction should be identified.
Shunichi Namiki Ph.D.1,2 Department of Urology, Tohoku University Graduate School of Medicine and 2Department of Urology, Japan Community Health Care Organization Sendai Hospital, Sendai, Japan [email protected]
1
DOI: 10.1111/iju.12692
Conflict of interest None declared.
References 1. Arai Y, Egawa S, Tobisu K et al. Radical retropubic prostatectomy: Time trends, morbidity and mortality in Japan. BJU Int. 2000; 85: 287–94. 2. Bayoud Y, de la Taille A, Ouzzane A et al. International Prostate Symptom Score is a predictive factor of lower urinary tract symptoms after radical prostatectomy. Int. J. Urol. 2015; 22: 283–7. 3. Namiki S, Kaiho Y, Mitsuzuka K et al. Long-term quality of life after radical prostatectomy: 8-Year longitudinal study in Japan. Int. J. Urol. 2014; 21: 1220–6. 4. Taub DA, Wei JT. The economics of benign prostatic hyperplasia and lower urinary tract symptoms in the United States. Curr. Urol. Rep. 2006; 7: 272–81. 5. Prabhu V, Sivarajan G, Taksler GB, Laze J, Lepor H. Long-term Continence Outcomes in Men Undergoing Radical Prostatectomy for Clinically Localized Prostate Cancer. Eur. Urol. 2014; 65: 58–65.
287
Copyright of International Journal of Urology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
