Patterns of Benign Prostate Hyperplasia Based on Magnetic Resonance Imaging Are Correlated With Lower Urinary Tract Symptoms and Continence in Men Undergoing a Robot-assisted Radical Prostatectomy for Prostate Cancer
| Autor: | Stijn W.T.P.J. Heijmink, Erik van Muilekom, Daan Schouten, Henk G. van der Poel, Corinne Tillier, Rosanne van der Roest, Nikolaos Grivas, Ivo G. Schoots |
|---|---|
| Přispěvatelé: | Dermatology, Radiology & Nuclear Medicine |
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Laparoscopic radical prostatectomy Urology medicine.medical_treatment 030232 urology & nephrology Prostatic Hyperplasia urologic and male genital diseases 03 medical and health sciences Prostate cancer 0302 clinical medicine Lower Urinary Tract Symptoms SDG 3 - Good Health and Well-being Prostate Lower urinary tract symptoms medicine Humans Postoperative Period Aged Retrospective Studies Prostatectomy medicine.diagnostic_test business.industry Prostatic Neoplasms Magnetic resonance imaging Robotics Middle Aged medicine.disease Magnetic Resonance Imaging medicine.anatomical_structure 030220 oncology & carcinogenesis Preoperative Period Prostate surgery International Prostate Symptom Score Laparoscopy business Follow-Up Studies |
| Zdroj: | Urology, 107, 196-201. Elsevier Inc. |
| ISSN: | 1527-9995 0090-4295 |
| DOI: | 10.1016/j.urology.2017.05.047 |
| Popis: | Objective To investigate the association between benign prostatic hyperplasia (BPH) patterns, classified by magnetic resonance imaging (MRI), with lower urinary tract symptoms (LUTS) or continence, preoperatively and after robot-assisted laparoscopic radical prostatectomy (RARP). Materials and Methods This retrospective study included 49 prostate cancer patients, with prostate size >47 cm3, who underwent an endorectal MRI followed by RARP. Five BPH patterns were identified according to Wasserman, and additional prostate measurements were recorded. LUTS were assessed using the International Prostate Symptom Score and the PR25-LUTS-Questionnaire score. Continence was assessed using the International Consultation of Incontinence Questionnaire-Short Form. Results BPH pattern 3 (44.9%) was identified most common, followed by pattern 5 (26.6%), 1 (24.5%), and 2 and 4 (both 2%). BPH patterns were significant predictors of preoperative LUTS, with pedunculated with bilateral transition zone (TZ) and retrourethral enlargement (pattern 5) causing more severe symptoms compared with bilateral TZ and retrourethral enlargement (pattern 3) and bilateral TZ enlargement (pattern 1), whereas pattern 3 was additionally associated with more voiding symptoms compared with pattern 1. None of the BPH patterns was predictive of postoperative LUTS and continence. Independent predictors of continence at 12 months were lower preoperative PR25-LUTS score (P = .022) and longer membranous urethral length (P = .025). Conclusion MRI is useful for classifying patients in BPH patterns which are strongly associated with preoperative LUTS. However, BPH patterns did not predict remnant LUTS or postoperative incontinence. Postoperative continence status was only associated with preoperative LUTS and membranous urethra length. |
| Databáze: | OpenAIRE |
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