Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Mar;207(3):601-608.
doi: 10.1097/JU.0000000000002312. Epub 2021 Oct 25.

De Novo Urinary Storage Symptoms Are Common after Radical Prostatectomy: Incidence, Natural History and Predictors

Kathleen M Kan  1 , Amy L Tin  2 , Gillian L Stearns  3 , James A Eastham  2 , Daniel D Sjoberg  2 , Jaspreet S Sandhu  2
Affiliations

De Novo Urinary Storage Symptoms Are Common after Radical Prostatectomy: Incidence, Natural History and Predictors

Kathleen M Kan et al. J Urol. 2022 Mar.

Abstract

Purpose: After radical prostatectomy (RP), clinical complaints of new onset storage symptoms may be related to anastomotic strictures or may accommodate for stress urinary incontinence; however, a subgroup of men will experience de novo storage symptoms in the absence of stricture or stress urinary incontinence. As therapies for overactive bladder have improved, we sought to assess the prevalence, natural history and risk factors of de novo storage dysfunction in continent men.

Materials and methods: We retrospectively analyzed urinary symptom questionnaires completed by patients who were continent prior to RP and did not have postoperative anastomotic strictures at our institution from 2002 to 2019. De novo storage dysfunction, assessed as new onset or worsening urgency or frequency, was assessed at 6, 12, 18 and 24 months after RP, and association between it and patient and preoperative factors was determined.

Results: A total of 2,619 patients were included in the final analysis. An initial 34% of patients reported de novo storage symptoms at 6 months, which decreased to 26% at later followup. We found evidence that minimally invasive surgery and nonWhite race were associated with reporting worsening symptoms. The association between postoperative hematoma and worsening symptoms was less conclusive but was of clear clinical relevance (OR 3.15; 95% CI 1.04, 9.54; p=0.042).

Conclusions: A significant number of RP patients experience de novo storage symptoms. Patients who underwent minimally invasive surgery are at higher risk. At-risk patients should be counseled on the incidence of de novo storage symptoms and offered early treatment per overactive bladder guidelines.

Keywords: lower urinary tract symptoms; prostatectomy; urinary bladder, overactive.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Proportion of patients with de novo storage dysfunction (and 95% confidence interval) based on months after radical prostatectomy.
See this image and copyright information in PMC

Comment in

  • Editorial Comment.
    Elterman D, Chughtai B. Elterman D, et al. J Urol. 2022 Mar;207(3):608. doi: 10.1097/JU.0000000000002312.01. Epub 2021 Dec 8. J Urol. 2022. PMID: 34875870 No abstract available.

References

    1. Sanda MG, Dunn RL, Michalski J, Sandler HM, Northouse L, Hembroff L, Lin X, Greenfield TK, Litwin MS, Saigal CS, Mahadevan A, Klein E, Kibel A, Pisters LL, Kuban D, Kaplan I, Wood D, Ciezki J, Shah N, & Wei JT (2008). Quality of life and satisfaction with outcome among prostate-cancer survivors. The New England journal of medicine, 358(12), 1250–1261. 10.1056/NEJMoa074311 - DOI - PubMed
    1. Shim Myungsun, Kim Jongwon, Park Sejun, Choi Seung-Kwon, Sang Lee Mi Kyeong Huh Ohk, Song Cheryn, Choo Myung-Soo, and Ahn Hanjong. “The Therapeutic Effect of Solifenacin Succinate on the Recovery From Voiding Dysfunction After Radical Prostatectomy in Men With Clinically Localized Prostate Cancer: A Prospective, Randomized, Controlled Study.” Urology 85.5 (2015): 1123–129. Web. - PubMed
    1. Porena Massimo, Mearini Ettore, Mearini Luigi, Vianello Alberto, and Giannantoni Antonella. “Voiding Dysfunction after Radical Retropubic Prostatectomy: More than External Urethral Sphincter Deficiency.”European Urology 52.1 (2007): 38–45. Web. - PubMed
    1. Giannantoni Antonella, Mearini Ettore, Zucchi Alessandro, Costantini Elisabetta, Mearini Luigi, Bini Vittorio, and Porena Massimo. “Bladder and Urethral Sphincter Function after Radical Retropubic Prostatectomy: A Prospective Long-Term Study.” European Urology 54.3 (2008): 657–64. Web. - PubMed
    1. Boettcher Martin, Haselhuhn Angelika, Jakse Gerhard, Brehmer Bernhard, and Ruth Kirschner-Hermanns. “Overactive Bladder Syndrome: An Underestimated Long-term Problem after Treatment of Patients with Localized Prostate Cancer?” BJU International 109.12 (2011): 1824–830. Web. - PubMed