Advances in Clinical and Experimental Medicine

Adv Clin Exp Med
Impact Factor (IF) – 1.514
Index Copernicus (ICV 2018) – 157.72
MNiSW – 40
Average rejection rate – 84.38%
ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download PDF

Advances in Clinical and Experimental Medicine

2019, vol. 28, nr 3, March, p. 391–395

doi: 10.17219/acem/79935

Publication type: review article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Creative Commons BY-NC-ND 3.0 Open Access

A hypothesis for the mechanism of urine incontinence in patients after radical prostatectomy due to urinary bladder hypertrophy

Kajetan Juszczak1,A,B,C,D,E,F, Adam Ostrowski2,A,B,D, Michał Bryczkowski2,A,B,D, Przemysław Adamczyk3,A,B,D, Tomasz Drewa2,3,A,D,E,F

1 Department of Urology, Ludwik Rydygier Memorial Specialized Hospital, Kraków, Poland

2 Department of General and Oncologic Urology, Nicolaus Copernicus University, Bydgoszcz, Poland

3 Department of General and Oncological Urology, Nicolaus Copernicus Hospital, Toruń, Poland

Abstract

Prostate cancer is one of the most common neoplasms in elderly males in Europe and is rapidly becoming a major health burden throughout the world. Radical prostatectomy is a first-line treatment in the case of organ-confined prostate cancer and in selected cases of locally advanced disease. Recent studies have suggested that the urinary bladder wall thickness (BWT) is an important predictor of an overactive bladder (OAB). This article focuses on a hypothesis for the mechanism of urine incontinence in patients after radical prostatectomy due to urinary bladder hypertrophy. To verify the possible influence of changes in the urinary bladder structure on urine incontinence development, we designed an experiment in which patients with prostate cancer were qualified for radical prostatectomy. Our hypothesis that urinary bladder hypertrophy influences urine incontinence development in patients after radical prostatectomy may provide an insight toward the prevention and control of urine incontinence after surgery by oral pharmacotherapy or intravesical onabotulinumtoxinA injections in pre-radical prostatectomy mode.

Key words

urinary incontinence, hypertrophy, urinary bladder, prostatectomy, structural changes

References (24)

  1. Arnold M, Karim-Kos HE, Coebergh JW, et al. Recent trends in incidence of five common cancers in 26 European countries since 1988: Analysis of the European Cancer Observatory. Eur J Cancer. 2015;51(9):1164–1187.
  2. Bianco FJ, Scardino PT, Eastham JA. Radical prostatectomy: Long-term cancer control and recovery of sexual and urinary function (“trifecta”). Urology. 2005;66(5):83–94.
  3. Kelleher CJ, Resse PR, Pleil AM, Okano GJ. Health-related quality of life of patients receiving extended-release tolterodine for overactive bladder. Am J Manag Care. 2002;8(Suppl 19):S608–S615.
  4. Adamczyk P, Tworkiewicz J, Drewa T. Radical prostatectomy specimens: A voice against focal therapy. Cent European J Urol. 2014;67(3):235–241.
  5. Ficarra V, Novara G, Rosen RC, et al. Systematic review and meta-analysis of studies reporting urinary continence recovery after robotic-assisted radical prostatectomy. Eur Urol. 2012;62(3):405–417.
  6. Pastore AL, Palleschi G, Illiano E, Zucchi A, Carbone A, Costantini E. The role of detrusor overactivity in urinary incontinence after radical prostatectomy: A systemic review. Minerva Urol Nefrol. 2017;69(3):234–241.
  7. Heesakkers J, Farag F, Bauer RM, Sandhu J, De Ridder D, Stenzl A. Pathophysiology and contributing factors in postprostatectomy incontinence: A review. Eur Urol. 2017;71(6):936–944.
  8. Blaivas JG, Marks BK, Weiss JP, Panagopoulos G, Somaroo C. Differential diagnosis of overactive bladder in men. J Urol. 2009;182(6):2814–2817.
  9. Porena M, Mearini E, Mearini L, Vianello A, Giannantoni A. Voiding dysfunction after radical retropubic prostatectomy: More than external urethral sphincter deficiency. Eur Urol. 2007;52(1):38–45.
  10. Boettcher M, Haselhuhn A, Jakse G, Brehmer B, Kirschner-Hermanns R. Overactive bladder syndrome: An underestimated long-term problem after treatment of patients with localized prostate cancer? BJU Int. 2012;109(12):1824–1830.
  11. Hosier GW, Tennankore KK, Himmelman JG, Gajewski J, Cox AR. Overactive bladder and storage lower urinary tract symptoms following radical prostatectomy. Urology. 2016;94:193-7. doi: 10.1016/j.urology.2016.05.007
  12. Novara G, Ficarra V, D’Elia C, et al. Evaluating urinary continence and preoperative predictors of urinary continence after robot-assisted laparoscopic radical prostatectomy. J Urol. 2010;184(3):1028–1033.
  13. Song C, Lee J, Hong JH, Choo MS, Kim CS, Ahn H. Urodynamic interpretation of changing bladder function and voiding pattern after radical prostatectomy: A long-term follow-up. BJU Int. 2010;106(5):681–686.
  14. Güzel Ö, Aslan Y, Balci M, et al. Can bladder wall thickness measurement be used for detecting bladder outlet obstruction? Urology. 2015;86(3):439–444.
  15. Hakenberg OW, Linne C, Manseck A, Wirth MP. Bladder wall thickness in normal adults and men with mild lower urinary tract symptoms and benign prostatic enlargement. Neurourol Urodyn. 2000;19(5): 585–593.
  16. Kuo HC. Measurement of detrusor wall thickness in women with overactive bladder by transvaginal and transabdominal sonography. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(11):1293–1299.
  17. Yang JM, Huang WC. Bladder wall thickness on ultrasonographic cystourethrography: Affecting factors and their implications. J Ultrasound Med. 2003;22(8):777–782.
  18. Khullar V, Cardozo LD, Salvatore S, Hill S. Ultrasound: A noninvasive screening test for detrusor instability. Br J Obstet Gynaecol. 1996;103(9):904–908.
  19. Ali MM, Ahmed A-F, Khaled SM, Abozeid H, AbdelMagid ME. Accuracy of ultrasound-measured bladder wall thickness for diagnosis of detrusor overactivity. African J Urol. 2015;21(1):25–29.
  20. Lin YT, Chou ECL. Assessment of overactive bladder (OAB): Symptom scores. Incont Pelvic Floor Dysfunct. 2009;3(Suppl 1):9–14.
  21. Blaivas JG, Panagopoulos G, Weiss JP, Somaroo C. Validation of the overactive bladder symptom score. J Urol. 2007;178(2):543–547.
  22. Homma Y, Yoshida M, Seki N, et al. Symptom assessment tool for overactive bladder syndrome: Overactive bladder symptom score. Urology. 2006;68(2):318–323.
  23. Kojima M, Inui E, Ochiai A, Naya Y, Ukimura O, Watanabe H. Ultrasonic estimation of bladder weight as a measure of bladder hypertrophy in men with infravesical obstruction: A preliminary report. Urology. 1996;47(6):942–947.
  24. Chalana V, Dudycha S, Yuk JT, McMorrow G. Automatic measurement of ultrasound-estimated bladder weight (UEBW) from three-dimensional ultrasound. Rev Urol. 2005;7(Suppl 6):S22–S28.