Journal of Reconstructive Urology

.: ORIGINAL RESEARCH
The Role of Urodynamics in the Evaluation of Lower Urinary Tract Symptoms After Postoperative Radiotherapy: A Retrospective Cross-Sectional Study
Postoperatif Radyoterapi Sonrası Alt Üriner Sistem Semptomlarının Değerlendirilmesinde Ürodinaminin Rolü: Retrospektif Kesitsel Çalışma
Selvi DİNÇERa, M. Gökhan ÇULHAb
aClinic of Radiation Oncology, Prof. Dr. Cemil Taşcıoğlu City Hospital, İstanbul, TURKEY
bClinic of Urology, Prof. Dr. Cemil Taşcıoğlu City Hospital, İstanbul, TURKEY
J Reconstr Urol. 2021;11(3):147-54
doi: 10.5336/urology.2021-86612
Article Language: EN
Full Text
ABSTRACT
 Objective: The aim of this study was to evaluate lower urinary tract symptoms (LUTS) and urodynamic parameters in patients with prostate cancer who received adjuvant radiotherapy (ART) or salvage radiotherapy (SRT) following open radical prostatectomy (RP) or robot-assisted radical prostatectomy (RARP) by using urodynamic parameters. Material and Meth ods: Patients who were treated with ART or SRT following RP or RARP due to prostate cancer were included. International Consultation on Incon tinence Questionnaire-Urinary Incontinence Short Form (ICIQ-SF) and Inter national Prostate Symptom Score (IPSS) questionnaires were filled in for the evaluation of LUTS for each irradiated patient. Urodynamic parameters such as bladder pressure, maxi mum cystometric capacity, maximum urethral pressure, maximum urethral clo sure pressure used for diagnosis of intrinsic sphincteric deficiency (ISD), and urethral length were recorded. Results: Fifty patients had un dergone open RP, while 48 had undergone RARP. ART and SRT was applied with 55 and 43 patients, respectively.There was no significant difference between the groups in terms of IPSS and ICIQ-SF scores, urgency-related measurements and maximum cystometric capacity values. Findings in filling cystometry were not significant in comparison of both RP and radiotherapy technique (p>0.05). Maximum urethral closure pressure values were significantly higher in RARP recipients, the frequency of ISD was significantly higher in the open RP group, and ure thral length was longer in the RARP group. Conclusion: No significant differ ence was found in terms of LUTS in patients who underwent ART or SRT after RP. RARP had positive effects on functional urethral length, urethral clo sure pressures and ISD frequency, regardless of timing of radiotherapy.

Keywords: Prostate cancer; urodynamics; incontinence; radiotherapy; radical prostatectomy
ÖZET
 Amaç: Bu çalışmanın amacı, prostat kanseri nedeniyle açık radikal prosta tektomi (RP) veya robot yardımlı radikal prostatektomi [robot-assisted radical pro statectomy (RARP)] sonrası adjuvan radyoterapi (ART) veya kurtarma radyoterapisi [salvage radiotherapy (SRT)] uygulanan hastalarda alt üriner sistem semptomları (AÜSS) ve ürodinamik parametreleri, ürodinamik testler kullanarak değerlendir mektir. Gereç ve Yöntemler: Prostat kanseri nedeniyle RP veya RARP sonrası ART veya SRT uygulanan hastalar dâhil edildi. AÜSS'nin değerlendi rilmesi için Uluslararası İnkontinans Anketi-Üriner İnkontinans Kısa Formu [Inter national Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-SF)] ve Uluslararası Prostat Semptom Skoru [International Prostate Symptom Score (IPSS)] anketleri radyoterapi uygulanan her hasta için dolduruldu. Mesane basıncı, maksimum sistometrik kapasite, maksimum üretral basınç, intrinsik sfinkterik yetersizlik (ISD) tanı sında kullanılan maksimum üretral kapanma basıncı ve üretral uzunluk gibi ürodi namik parametreler kaydedildi. Bulgular: Elli hastada açık RP ve 48 hastada RARP uygulandı. ART ve SRT sırasıyla 55 ve 43 hastaya uygulandı. Gruplar arasında IPSS ve ICIQ-SF skorları, ani sıkışma hissi ile ilgili hacimler ve maksimum sistometrik kapasite değerleri açısından anlamlı fark yoktu. Dolgu sistometrisindeki bulgular hem RP hem de RT tekniği karşılaştırıldığında anlamlı değildi (p>0.05).RARP uygulananlarda maksimum üretral kapanma ba sıncı değerleri anlamlı olarak daha yüksekti, açık RP grubunda ise ISD sıklığı anlamlı olarak daha yüksekti ve RARP grubunda üretral uzunluk anlamlı olarak daha uzundu. Sonuç: RP sonrası ART veya SRT uygulanan hastalarda AÜSS açı sından anlamlı fark bulunmadı. Radyoterapi uygulama zamanından bağımsız olarak, RARP'nin fonksiyonel üretral uzunluk, üretral kapanma basınçları ve ISD sıklığı üzerinde olumlu etkileri olduğu bulundu.

Anahtar Kelimeler: Prostat kanseri; ürodinami; inkontinans; radyoterapi; radikal prostatektomi
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