Lower Urinary Tract Functional Assessment of Men Undergoing Radical Prostatectomy; Correlation of Preoperative Clinical and Urodynamic Parameters.

Purpose To assess baseline clinical and urodynamic profiles of a contemporary cohort of men undergoing radical prostatectomy as part of the ROSE study. Methods Men with localised prostate cancer undergoing radical prostatectomy were prospectively recruited to undergo clinical assessment and urodynamic testing prior to surgery as part of a clinical trial. Results 85 men with median age 64.5 years and median PSA 6.3 ng/ml were prospectively recruited. Of patients with complete baseline data, 36(50.7%), 28(39.4%) and 7(9.9%) had mild (IPSS 20) LUTS. Obstruction was identified in 18 (29.5%) men and 9 (14.8%) showed detrusor underactivity. Of 15 patients with detrusor overactivity, 12(80%) reported OAB. Of men with urodynamic obstruction, 5 (31.3%), 10(62.5%) and 1(6.3%) reported mild, moderate and severe LUTS. Of men without OAB, 4 (11.8%, p=0.002) showed filling phase abnormalities, 13 (46.4%, p=0.611) had flow rates < 15ml/s and 7 (30.4%, p=0.767) were obstructed. Of men with mild or absent LUTS, 5 (20%, p=0.072) were obstructed and 4 (16%, p=0.524) showed poor contractility. Conclusions LUTS and OAB are common in men with localised prostate cancer undergoing radical prostatectomy. Detrusor overactivity and urodynamic filling phase abnormalities are strongly correlated with OAB. IPSS did not correlate well with bladder outflow obstruction or detrusor underactivity. Urodynamic filling abnormalities were found in 11.8% of men without OAB. Symptomatic and functional assessment may therefore have a role in the preoperative counselling of patients and possibly guide post-operative management of LUTS especially if OAB is present.