title: Changes in Urodynamics and Lower Urinary Tract Symptoms after Radical Prostatectomy: Implications of Preoperative Detrusor Contractility.
abstract: OBJECTIVE
  Our goal was to identify changes in urodynamic parameters and lower urinary tract symptoms (LUTS) in men followed for1 year after radical prostatectomy (RP) compared to the preoperative measures with a specific focus on detrusor contractility.
  
  
  METHODS
  This study enrolled 43 patients who received RP (laparoscopic 27, retropubic: 16) and pressure flow studies (PFS) pre-RP as well as 12 months (M) after RP. No patients complained of urinary incontinence preoperatively. Urodynamic studies and questionnaires regarding LUTS and urinary continence were conducted before and 12 M after RP. Detrusor underactivity (DU) was defined as <10 (W/m(2) ) in preoperative maximum watts factor value.
  
  
  RESULTS
  Urodynamics demonstrated that RP improved urodynamic parameters by releasing bladder outlet obstruction without affecting overall detrusor contractility. Meanwhile, RP did not affect bladder capacity, bladder compliance, or detrusor contractility. LUTS in the International Prostate Symptom Score (IPSS), including the IPSS subscore, was not improved. The quality of life score was significantly better at 12 M after RP and continence rates were gradually improved to be at a satisfactory level in more than 80% of patients by 12 M after RP. DU was preoperatively identified in 21(49%) patients, influencing urodynamic parameters and LUTS preoperatively. However, DU did not affect urodynamic parameters and LUTS after RP.
  
  
  CONCLUSIONS
  Although RP improves urodynamic parameters, it does not significantly affect LUTS. Urinary continence gradually improves and is satisfactory within 1 year after RP. The status of preoperative detrusor contractility did not affect urodynamic parameters or LUTS after RP.
authors.affiliation: Department of Urology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan.
authors.forename: Takahiko
authors.initials: T
authors.lastname: Mitsui
authors.affiliation: Department of Urology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Department of Urology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Harabayashi
authors.affiliation: Department of Urology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan.
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Moriya
authors.affiliation: Department of Urology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Maruyama
authors.affiliation: Department of Urology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan.
authors.forename: Takashige
authors.initials: T
authors.lastname: Abe
authors.affiliation: Department of Urology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan.
authors.forename: Ataru
authors.initials: A
authors.lastname: Sazawa
authors.affiliation: Department of Urology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Shinohara
authors.affiliation: Department of Urology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Nonomura
keywords: detrusor underactivity; lower urinary tract symptoms; radical prostatectomy; urinary incontinence; urodynamics