Vesicourethral anastomotic strictures and urinary incontinence following radical prostatectomy: relationship and impact on patients’ quality of life before and after endoscopic correction


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Abstract

Aim To assess the incidence and grade of concomitant stress urinary incontinence (SUI) and the quality of life before and after endoscopic correction of vesicourethral anastomotic strictures (VAS) and the impact of the number of endoscopic interventions on these indicators. Materials and methods This is a retrospective study of medical records and a telephone survey of patients who underwent radical prostatectomy (RP) at our clinic from 2010 to 2015 and subsequently presented with VAS. The survey included data on the severity of SUI and quality of life using QoL questionnaire before and after endoscopic VAS correction; the factors primarily affecting the quality of life (SUI or obstructive symptoms) were identified. Results During the above period, 1453 RP were performed. There were 60 VAS cases, of which 56 (93%) were included in the study. Stress urinary incontinence after RP occurred in 64.3% of patients, the average QoL score was 3.95 (a = 0.64; Cv = 16.2%). Before endoscopic VAS correction, 87.5% of patients reported obstructive symptoms as the main cause of dissatisfaction. After endoscopic VAS correction, SUI was observed in 82.1% of patients. De novo incontinence occurred in 15 patients, higher SUI grade was observed in 29 (51.8%) patients. The observed change in the of SUI grade was not statistically significant (paired Student’s t-test 1.98, p> 0.05). Mean QoL score after endoscopic correction was 2.54 (a = 0.73; Cv = 28.6%, paired Student’s t-test 5.08, p <0.05). After endoscopic correction of VAS, 78.6% of the patients reported that SUI was the most important factor for decreased quality of life. Conclusions The study revealed a high incidence of VAS combined with SIU. There was a significant improvement in patients’ quality of life after endoscopic correction of VAS, which resulted from a change in the pattern of voiding dysfunction producing a major negative impact on the quality of life. There were no statistically significant correlations between the number of endoscopic corrections of VAS and the SUI grade and the patients’ quality of life.

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About the authors

I. A Reva

A.I. Evdokimov MSUMD

Email: rewa-igor@rambler.ru
Urologist at Clinical Medical Center of MSUMD

A. V Zhivov

A.I. Evdokimov MSUMD

Email: azhivov@emcmos.ru
Department of Urology

A. V Okishev

A.I. Evdokimov MSUMD

Email: okishev.art@gmail.com
Department of Urology

V. V D’yakov

A.I. Evdokimov MSUMD

Email: dr.diakov@gmail.com
Department of Urology

A. N Bernikov

A.I. Evdokimov MSUMD

Email: bernikov@mac.com
Department of Urology

A. V Bormotin

A.I. Evdokimov MSUMD

Email: bormotin@nm.ru
Department of Urology

D. Yu Pushkar

A.I. Evdokimov MSUMD

Email: pushkardm@mail.ru
Department of Urology

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