[Voiding dysfunction in prostate cancer]

Abstract

Objectives: Prostate cancer is the urologic neoplasia that has experienced more changes in the last decade, with a great increase in incidence and diagnosis. Prostate cancer patient's management is clearly multidisciplinary, with the participation of urologists mainly, but also specialized pathologists, radiologists, biochemists, medical oncologists, radiation oncologists and others. The expected long survival makes the routine visit for PSA control non sustainable, without paying attention to the presence of urinary symptoms and other functional disorders with great repercussion on the quality of life.

Objectives: To present urinary dysfunction in patients with prostate cancer from a non oncological but urodynamic and quality of life point of view. Secondarily, to pose the clinical features not translated to functional and urodynamic pathology (urinary toxicity, radiation toxicity, bladder hyperactivity...)

Methods: We review and update voiding dysfunction that may be present in prostate cancer patients. Not only urinary incontinence after radical prostatectomy. We integrated author;s experience with its physiopathology, sphincter electromyography, and urodynamics, and a general review on the topic using the latest bibliography.

Results: Surgical techniques have improved very much, resulting in very high continence rates, which do not enable to consider one approach or the use of robotics better than others. Prostate cancer present multiple urodynamic scenarios. Constrictive or compressive lower urinary tract obstruction, detrusor muscle hyperactivity, diminished compliance, stress urinary incontinence due to sphincteric deficit, mixed urinary incontinence, bladder dysfunction. Other scenarios are not defined by urodynamics.

Conclusions: Patients with prostate cancer may currently receive a defective evaluation by their urologists in terms of urinary symptoms due to the prevalence of oncological features in their evaluation. Prostate cancer shows a great diversity of urodynamic scenarios subject of study, not only post-radical prostatectomy incontinence.