Does radical prostatectomy result in lower urinary tract symptom improvement in high-risk and locally advanced prostate cancer? A Single-center experience

Urologia. 2021 May;88(2):110-114. doi: 10.1177/0391560320964611. Epub 2020 Oct 10.

Abstract

Purpose: Radical prostatectomy represents the most popular method of prostate cancer treatment, including cases with high-risk and locally advanced cancer. Besides, men with this disease often experience lower urinary tract symptoms (LUTS) and report high International Prostate Symptom Scores (IPSS), pathological post-void residual (PVR) urine volumes and low levels of maximum urinary flow rates (Qmax). In this study we assessed the effect of radical prostatectomy on the above parameters in patients with high-risk and locally advanced disease.

Methods: A number of 240 individuals were enrolled in the study. Patients that required any post-operative manipulation up to the completion of 12 months after surgery were excluded. All patients were assessed pre- and post-operatively at 3, 6 and 12 months. Evaluation included IPSS, Qmax and PVR.

Results: Mean age was 66.8 years. Mean PSA value was 12.7 ng/ml and mean Gleason score was 7.9. At baseline 41.3% of the patients had Qmax ⩽10 and 42.5% had IPSS >8. There was a significant increase in Qmax during the follow-up (median value was 12 at baseline and increased to 21 at 12 months). Also, IPSS and PVR decreased significantly during the follow-up. IPSS median value decreased from 9 at baseline to 5 at 12 months. Improvement was observed in all grades of symptoms.

Keywords: High-risk prostate cancer; IPSS; LUTS; Qmax; locally advanced prostate cancer; lower urinary tract symptoms; open radical prostatectomy.

MeSH terms

  • Aged
  • Humans
  • Lower Urinary Tract Symptoms / etiology
  • Lower Urinary Tract Symptoms / surgery*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prostatectomy / methods*
  • Prostatic Neoplasms / complications
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / surgery*
  • Risk Assessment
  • Treatment Outcome