67th Annual Meeting Abstracts
Which Men Benefit Most in Improvement of LUTS after Robotic Prostatectomy?
Ornob P Roy, *Kasey Y Morrison, William D Steers
University of Virginia, Charlottesville, VA
Introduction
We attempted to identify pre-operative predictors for reduction in lower urinary tract symptoms (LUTS) after robotic-assisted laparoscopic radical prostatectomy (RALRP).
Methods
A retrospective analysis was performed on men who underwent RALRP for prostate cancer (PCa). Variables examined by descriptive and univariate analyses include age, prostate size, inflammation on biopsy, and change in International Prostate Symptom Score (IPSS).
Results
Our study identified 121 men between 2003 and 2009 who had RALRP with at least 6 months follow-up (average 29 months). Fifty-one men had a pre-operative moderate-to-severe LUTS. Of these men, 80% had improvement of their LUTS (mean of 7.6 points). Men with high pre-operative IPSS (>=8) had greater reduction in IPSS (p<0.0001). When stratified into age groups, reductions in IPSS directly correlated; with age <50=33% (n= 6), 50-60=43% (n=60), 60-70=61% (n=44), and >70=64% (n=11). Men with prostate size >35g experienced greater improvement in LUTS (37% vs 19%, p=0.02). Men with inflammation on pre-operative biopsy trended towards greater reduction in IPSS (5.7 vs 2.9, p=0.15). Five men predicted to improve by the above criteria fail to do so, but four had longstanding specific risk factors including stroke, low-compliance bladder, and detrussor overactivity.
Conclusions
Our data suggests that 80% of older men with significant pre-operative LUTS and large prostates can expect significant improvement of their LUTS post-operatively. Men with certain conditions known to impact bladder function are less likely to improve. Whether this degree of improvement offers an advantage of RALRP over other treatments for PCa is the subject of future study.
