title: Quantification of Long-term Stability and Specific Relief of Lower Urinary Tract Symptoms (LUTS) After Robot-assisted Radical Prostatectomy.
abstract: OBJECTIVE
  To assist in preoperative counseling by assessing long-term changes in American Urological Association symptom scores (AUAss) and lower urinary tract symptom (LUTS)-related quality of life (QOL) in patients undergoing robot-assisted radical prostatectomy (RARP).
  
  
  METHODS
  RARP was performed on 666 men by one surgeon from 2002 to 2007 at a single institution. AUAss and QOL were queried preoperatively and at 3, 9, 15, 24-48, 60-84, and 96+ months postoperatively. LUTS subgroups were compared pre-/postsurgery using univariate and multivariate statistics.
  
  
  RESULTS
  The mean and median follow-up for all responders was 3.0 and 2.4 years. Pad-free continence at 12 months was 89%. A subset of 174 men reported preoperative and long-term responses; average follow-up was 5.8 years (range 4.0-10.3 years). AUAss for all men declined from baseline to 5 years by 3.7 (8.6 to 4.8) whereas QOL/Bother scores decreased by 0.5 (1.7 to 1.2) (all P < .05). Men with baseline mild LUTS remained clinically unchanged with long-term AUAss. Individuals with moderate and severe preoperative LUTS had marked improvements in AUA and QOL scores (all P ≤ .05).
  
  
  CONCLUSIONS
  Men with mild LUTS have short-term increases in AUAss but most return to baseline and are stable at 5 years. Benefits were found for men with preoperative moderate and severe LUTS in that 63% had significant QOL improvements and 68% reduced their AUAss to mild LUTS, persisting years after RARP. This study suggests that certain patients with preoperative urinary symptoms and bother may experience improvements in LUTS and associated QOL after RARP.
authors.affiliation: Department of Urology, University of California, Irvine, Orange, CA.
authors.forename: Adam
authors.initials: A
authors.lastname: Gordon
authors.affiliation: Department of Urology, University of California, Irvine, Orange, CA. Electronic address: dwskarec@uci.edu.
authors.forename: Douglas
authors.initials: D
authors.lastname: Skarecky
authors.affiliation: Department of Urology, University of California, Irvine, Orange, CA.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Osann
authors.affiliation: Division of Urology, Rochester General Hospital, Rochester, NY.
authors.forename: Louis
authors.initials: L
authors.lastname: Eichel
authors.affiliation: Department of Urology, University of California, Irvine, Orange, CA.
authors.forename: Harleen
authors.initials: H
authors.lastname: Dhaliwal
authors.affiliation: Department of Urology, University of California, Irvine, Orange, CA.
authors.forename: Blanca
authors.initials: B
authors.lastname: Morales
authors.affiliation: Department of Urology, University of California, Irvine, Orange, CA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Ahlering
mesh_terms: D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D011788:Quality of Life; D012074:Remission Induction; D065287:Robotic Surgical Procedures; D013997:Time Factors; D016896:Treatment Outcome