UP-122 Urodynamics finding of detrusor overactivity underestimates the prevalence of overactive bladder in men following radical prostatectomy
Thursday June 27, 2019 from
TBD
Presenter

Henry Han-I Yao, Canada

Urology Fellow

Vesia (Alberta Bladder Centre)

Abstract

Urodynamics finding of detrusor overactivity underestimates the prevalence of overactive bladder in men following radical prostatectomy

Henry Han-I Yao1,2,3, Robert Trafford Crump2, Jing Jiang2, Carly Barton1,2, Catalina Vasquez4, John Lewis4, Kevin V. Carlson1,2, Richard J. Baverstock1,2.

1Vesia [Alberta Bladder Centre], Southern Alberta Institute of Urology, Calgary, AB, Canada; 2Department of Surgery, University of Calgary, Calgary, AB, Canada; 3Eastern Health Clinical School, Monash University, Melbourne, Australia; 4Department of Oncology, University of Alberta, Edmonton, AB, Canada

Dave Bateman. Prostate Cancer Centre, Southern Alberta Institute of Urology, Calgary, Alberta, Canada. Prostate Cancer Canada. Movember Foundation.

Introduction: This study aims to determine the rates of overactive bladder (OAB) in men with localised prostate cancer following treatment with radical prostatectomy (RP) as determined by OAB-V8 symptom score and urodynamics study. 

Methods: This is a prospective pre-post case series of Canadian men with newly diagnosed localized prostate cancer treated with RP. 31 men were recruited from June 2017 to July 2018. Clinicopathological data were extracted from medical records and Alberta Prostate Cancer Research Initiative database. Patient reported outcome measures (PROMs) including OAB-V8 and EPIC-26 short form were collected at baseline and 12 months. OAB was defined as OAB-V8 score >=8. Urodynamics study was offered only to men with OAB. Paired t-tests were used to compare PROMs score pre- and post-RP. Incontinence rate based on EPIC-26 was compared for men with and without OAB. Ethics approval was obtained for this study. 

Results: At baseline 54.8% of men had OAB, which increased to 64.5% at 12 months. There was no difference between baseline and 12 months OAB-V8 score on paired t-test. 41.9% of men had persistent OAB, 12.9% had resolution of OAB and 22.6% developed de novo OAB after RP.  Men without OAB had a higher continence rate post-RP based on EPIC-26 question 1 (90.0% vs 40%, p=0.008). Detrusor overactivity (DO) was found in 40% of men who underwent urodynamics at baseline and 38.5% post-RP.

Conclusions: OAB is present in approximately half of men with localised prostate cancer and can persist in the first twelve months following RP. This study suggests that men with OAB may have worse incontinence post-RP. This small series suggest that only ~40% of men with OAB based on an OAB-V8 have demonstrable DO on urodynamics. Therefore, treatment of OAB as a component of incontinence management post-RP should be optimised based on symptoms even in the absence of DO on urodynamics. Further prospective and larger studies are required to confirm the findings of this study.


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