Uroflow StopTest Following Robotic-assisted Radical Prostatectomy Can Predict Integrity of Pelvic Floor and Return of Erectile Function
CUA Online Library. Al-Hathal N. 06/25/13; 31304; MP-06.03
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Abstract
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Uroflow StopTest following robotic assisted radical prostatectomy can predict integrity of pelvic floor and return of erectile function
Naif Al-Hathal, Kevin Zorn, Assaad El-Hakim
Department of surgery, division of urology, Hopital Sacre Coeur de Montreal, Montreal, Qc, Canada
Introduction and objectives: Restoration of pelvic floor anatomy is crucial for the return of early urine continence after robotic assisted radical prostatectomy (RARP). On the other hand, recovery of erectile function is more dependent on pre-operative erection, age and the degree of nerve sparing. Furthermore, We showed the role of voluntary stop of urine flow during voiding in uroflowmeter ,at time of catheter removal after RARP, in the prediction of early return of urine continence and pelvic floor integrity. Recovery of urine continence and erectile function seem to “interplay” as it was shown that nerve sparing during RARP can improve the rates of urine continence after surgery. Interestingly, it is not clear whether early return of urine continence could predict the rate of erectile function recovery after RARP. Hence, the objective of this study is to examine the predictive role of positive uroflowmetery StopTest on erectile function after recovery following RARP.
Materials and Methods: In this prospective study, 108 patients with a minimum of 2 year follow-up, operated by a single surgeon (AEH) were subjected to an uroflowmetry at the time of urethral catheter removal following RARP. 44 patients of which met our inclusion criteria of pre-op SHIM ≥ 21. Our exclusion criteria were documented excision of neurovascular bundles and non-sexually active patients. Two groups were studied, group one with positive Stop Test (n=30) and group two with negative Stop Test (n=14). A positive StopTest is defined as the ability to stop urine flow voluntarily for more than 3 seconds provided that a maximum flow of at least 15 ml/sec was reached. Demographic, clinical and postoperative data were collected and analyzed. Urine continence was defined as 0-pads usage and potency defined as penetration during intercourse.
Results: Age, BMI, IPSS score, PSA, tumor stage, prostate volume, nerve sparing status and estimated blood loss were not statistically different between the two groups. Early continence recovery and return of potency were significantly faster in group one. The mean interval to return of urine continence in group one was 2.2 months (range 1-9 months), compared to 13.7 months (range 1-48 months) in group 2 (p=0.0001). On the other hand, the mean interval to return of potency in group one was 3.9 months (range 1-12 months), compared to 10.7 months (range 1-24 months).
Conclusion: Novel use of uroflowmetry at time of urethral catheter removal is simple, non-invasive and good indicator of pelvic floor integrity with independent ability to predict earlier return of potency and urine continence following RARP.
Naif Al-Hathal, Kevin Zorn, Assaad El-Hakim
Department of surgery, division of urology, Hopital Sacre Coeur de Montreal, Montreal, Qc, Canada
Introduction and objectives: Restoration of pelvic floor anatomy is crucial for the return of early urine continence after robotic assisted radical prostatectomy (RARP). On the other hand, recovery of erectile function is more dependent on pre-operative erection, age and the degree of nerve sparing. Furthermore, We showed the role of voluntary stop of urine flow during voiding in uroflowmeter ,at time of catheter removal after RARP, in the prediction of early return of urine continence and pelvic floor integrity. Recovery of urine continence and erectile function seem to “interplay” as it was shown that nerve sparing during RARP can improve the rates of urine continence after surgery. Interestingly, it is not clear whether early return of urine continence could predict the rate of erectile function recovery after RARP. Hence, the objective of this study is to examine the predictive role of positive uroflowmetery StopTest on erectile function after recovery following RARP.
Materials and Methods: In this prospective study, 108 patients with a minimum of 2 year follow-up, operated by a single surgeon (AEH) were subjected to an uroflowmetry at the time of urethral catheter removal following RARP. 44 patients of which met our inclusion criteria of pre-op SHIM ≥ 21. Our exclusion criteria were documented excision of neurovascular bundles and non-sexually active patients. Two groups were studied, group one with positive Stop Test (n=30) and group two with negative Stop Test (n=14). A positive StopTest is defined as the ability to stop urine flow voluntarily for more than 3 seconds provided that a maximum flow of at least 15 ml/sec was reached. Demographic, clinical and postoperative data were collected and analyzed. Urine continence was defined as 0-pads usage and potency defined as penetration during intercourse.
Results: Age, BMI, IPSS score, PSA, tumor stage, prostate volume, nerve sparing status and estimated blood loss were not statistically different between the two groups. Early continence recovery and return of potency were significantly faster in group one. The mean interval to return of urine continence in group one was 2.2 months (range 1-9 months), compared to 13.7 months (range 1-48 months) in group 2 (p=0.0001). On the other hand, the mean interval to return of potency in group one was 3.9 months (range 1-12 months), compared to 10.7 months (range 1-24 months).
Conclusion: Novel use of uroflowmetry at time of urethral catheter removal is simple, non-invasive and good indicator of pelvic floor integrity with independent ability to predict earlier return of potency and urine continence following RARP.
Uroflow StopTest following robotic assisted radical prostatectomy can predict integrity of pelvic floor and return of erectile function
Naif Al-Hathal, Kevin Zorn, Assaad El-Hakim
Department of surgery, division of urology, Hopital Sacre Coeur de Montreal, Montreal, Qc, Canada
Introduction and objectives: Restoration of pelvic floor anatomy is crucial for the return of early urine continence after robotic assisted radical prostatectomy (RARP). On the other hand, recovery of erectile function is more dependent on pre-operative erection, age and the degree of nerve sparing. Furthermore, We showed the role of voluntary stop of urine flow during voiding in uroflowmeter ,at time of catheter removal after RARP, in the prediction of early return of urine continence and pelvic floor integrity. Recovery of urine continence and erectile function seem to “interplay” as it was shown that nerve sparing during RARP can improve the rates of urine continence after surgery. Interestingly, it is not clear whether early return of urine continence could predict the rate of erectile function recovery after RARP. Hence, the objective of this study is to examine the predictive role of positive uroflowmetery StopTest on erectile function after recovery following RARP.
Materials and Methods: In this prospective study, 108 patients with a minimum of 2 year follow-up, operated by a single surgeon (AEH) were subjected to an uroflowmetry at the time of urethral catheter removal following RARP. 44 patients of which met our inclusion criteria of pre-op SHIM ≥ 21. Our exclusion criteria were documented excision of neurovascular bundles and non-sexually active patients. Two groups were studied, group one with positive Stop Test (n=30) and group two with negative Stop Test (n=14). A positive StopTest is defined as the ability to stop urine flow voluntarily for more than 3 seconds provided that a maximum flow of at least 15 ml/sec was reached. Demographic, clinical and postoperative data were collected and analyzed. Urine continence was defined as 0-pads usage and potency defined as penetration during intercourse.
Results: Age, BMI, IPSS score, PSA, tumor stage, prostate volume, nerve sparing status and estimated blood loss were not statistically different between the two groups. Early continence recovery and return of potency were significantly faster in group one. The mean interval to return of urine continence in group one was 2.2 months (range 1-9 months), compared to 13.7 months (range 1-48 months) in group 2 (p=0.0001). On the other hand, the mean interval to return of potency in group one was 3.9 months (range 1-12 months), compared to 10.7 months (range 1-24 months).
Conclusion: Novel use of uroflowmetry at time of urethral catheter removal is simple, non-invasive and good indicator of pelvic floor integrity with independent ability to predict earlier return of potency and urine continence following RARP.
Naif Al-Hathal, Kevin Zorn, Assaad El-Hakim
Department of surgery, division of urology, Hopital Sacre Coeur de Montreal, Montreal, Qc, Canada
Introduction and objectives: Restoration of pelvic floor anatomy is crucial for the return of early urine continence after robotic assisted radical prostatectomy (RARP). On the other hand, recovery of erectile function is more dependent on pre-operative erection, age and the degree of nerve sparing. Furthermore, We showed the role of voluntary stop of urine flow during voiding in uroflowmeter ,at time of catheter removal after RARP, in the prediction of early return of urine continence and pelvic floor integrity. Recovery of urine continence and erectile function seem to “interplay” as it was shown that nerve sparing during RARP can improve the rates of urine continence after surgery. Interestingly, it is not clear whether early return of urine continence could predict the rate of erectile function recovery after RARP. Hence, the objective of this study is to examine the predictive role of positive uroflowmetery StopTest on erectile function after recovery following RARP.
Materials and Methods: In this prospective study, 108 patients with a minimum of 2 year follow-up, operated by a single surgeon (AEH) were subjected to an uroflowmetry at the time of urethral catheter removal following RARP. 44 patients of which met our inclusion criteria of pre-op SHIM ≥ 21. Our exclusion criteria were documented excision of neurovascular bundles and non-sexually active patients. Two groups were studied, group one with positive Stop Test (n=30) and group two with negative Stop Test (n=14). A positive StopTest is defined as the ability to stop urine flow voluntarily for more than 3 seconds provided that a maximum flow of at least 15 ml/sec was reached. Demographic, clinical and postoperative data were collected and analyzed. Urine continence was defined as 0-pads usage and potency defined as penetration during intercourse.
Results: Age, BMI, IPSS score, PSA, tumor stage, prostate volume, nerve sparing status and estimated blood loss were not statistically different between the two groups. Early continence recovery and return of potency were significantly faster in group one. The mean interval to return of urine continence in group one was 2.2 months (range 1-9 months), compared to 13.7 months (range 1-48 months) in group 2 (p=0.0001). On the other hand, the mean interval to return of potency in group one was 3.9 months (range 1-12 months), compared to 10.7 months (range 1-24 months).
Conclusion: Novel use of uroflowmetry at time of urethral catheter removal is simple, non-invasive and good indicator of pelvic floor integrity with independent ability to predict earlier return of potency and urine continence following RARP.
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