Prostate Cancer Clinical Trial
Official title:
Could Urinary Bladder Hypertrophy Influence on Urge Urine Incontinence Development in Patients After Radical Prostatectomy: A Multi-center Study
This study is designed to evaluate men before radical prostatectomy for the incidence of Overactive Bladder (OAB), as well as urge urine incontinence (UUI) development after the surgery. Patients will be evaluated for signs of OAB and for signs of Bladder Outlet Obstruction (BOO). Afterwards they will be divided into four observational groups. Follow up period is designed to be 12 months.
Radical prostatectomy remains the standard treatment in case of organ-confined and in
selected cases of locally advanced prostate cancer. Radical prostatectomy consists of
removing the prostate gland and seminal vesicles, ideally with negative surgical margins.
Most of the patients who present urinary incontinence after radical prostatectomy have
stress urinary incontinence. However in some cases the post-surgical urinary incontinence is
also due to urgency caused by overactive bladder development defined as urge urinary
incontinence. Recent clinical observations suggest that men can also develop overactive
bladder after radical prostatectomy.
This study is designed to evaluate men before radical prostatectomy for the incidence of
Overactive Bladder (OAB) and it's development after the surgery. Before surgery
questionnaire assessment of lower urinary tract symptoms will be performed using
International Prostate Symptom Score (IPSS) questionnaire. OAB symptoms will be analyzed
using King's questionnaire, as well as using two different OAB symptom score (OABSS)
designed by Blavis et al. and Homma et al. Each patient will have transabdominal
ultrasonographic evaluation of the prostate and urinary bladder structure. Prostatic
dimensions width (W), height (H), length (L) and volume will be recorded. The
ultrasonography will be done in urinary bladder filling related to normal desire to void.
Urinary bladder wall thickness (BWT) and detrusor muscle thickness (DWT) will be measured in
sagittal plane in anterior bladder wall. The mean of three following measurements BWT and
DWT will be obtained. The urinary bladder weight (UEBW: Ultrasound Estimated Bladder Weight)
will be also estimated. After ultrasonography each patient will undergo uroflowmetry with
post-void residual estimation.
On the results above 4 groups will be formed
Group 1 OAB (-) BOO (-)
Group 2 OAB (-) BOO (+)
Group 3 OAB (+) BOO (+)
Group 4 OAB (+) BOO (-)
The investigators will obtain detail information about the surgery (time, blood loss,
histopathological outcome, nerve sparing, complications).
After the initial evaluation of the patients before surgery, the control evaluation is set
on 1, 3, 6, 9, and 12 month after radical prostatectomy in groups 1-4 to define the lower
urinary tract symptoms after radical prostatectomy related to pre-surgical patient clinical
feature. During each of the following controls the investigator will not have the access to
previously obtained data from the patient.
In addition, healthy volunteers aged 20 to 40 will be assigned as a control group.
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