Impacto de la prostatectomía radical en los resultados urodinámicos de pacientes con cáncer de próstata tratados con radioterapia de intensidad modulada / Impact of a radical prostatectomy on the urodynamic results of prostate cancer patients treated with intensity modulated radiation therapy

Introducción y objetivos Evaluar el efecto de la prostatectomía radical y la edad en los resultados urodinámicos antes y después de la radioterapia de intensidad modulada administrada a pacientes con cáncer de próstata. Materiales y métodos La muestra incluyó a 40 pacientes con cáncer de próstata, 22 de los cuales habían sido sometidos a prostatectomía radical. Se midieron y compararon los parámetros urodinámicos antes y después de una media de 4,2 meses de radioterapia. La radioterapia externa se administró mediante técnicas de terapia de arco volumétrico modulado y de radioterapia de intensidad modulada. Resultados No se vieron cambios significativos en los parámetros de uroflujometría. En el caso de la cistomanometría los datos no mostraron un aumento de la incontinencia urinaria de esfuerzo secundaria, pero sí un incremento del 7% en la incontinencia urinaria de urgencia. Hubo cambios estadísticamente significativos en la reducción de la capacidad vesical, con un deseo miccional fuerte, con urgencia miccional y también en la presión del detrusor con un deseo miccional normal. Además, el estudio de presión/flujo reveló una reducción estadísticamente significativa del volumen de orina residual. Conclusiones El efecto de la prostatectomía y la edad varía según la evolución del estudio urodinámico. Hubo una reducción significativa del volumen de orina residual, así como de la presión del detrusor, con un deseo miccional normal en los pacientes sin prostatectomía y en aquellos menores de 75 años. Además de un aumento en la incontinencia de urgencia, también se produjo un empeoramiento significativo del resultado urodinámico de llenado vesical y una disminución de la capacidad vesical cistomanométrica, con un deseo miccional fuerte y urgencia miccional. Ninguno de estos factores se vio afectado por la edad o la prostatectomía (AU)

Introduction and objectives To evaluate the effect of radical prostatectomy and age on urodynamics before and after intensity-modulated radiation therapy administered to prostate cancer patients. Materials and methods The sample consisted of 40 prostate cancer patients, 22 of whom had undergone a radical prostatectomy. Urodynamic parameters before and after an average of 4.2 months of radiotherapy were measured and compared. External radiotherapy was administered via Volumetric Modulated Arc Therapy (VMAT), Intensity Modulated Radiation Therapy (IMRT) techniques. Results Uroflowmetry presented no significant parameters. In the case of Cystomanometry, the data did not show an increase in secondary stress urinary incontinence, although there is 7 percent increase in urge urinary incontinence. There were statistically significant changes in reduced bladder capacity with a strong desire to void, with an urge to void and also in the detrusor pressure with a normal desire to void. Furthermore, pressure/flow analysis revealed a statistically significant reduction of residual urine volume. Conclusions The effect of prostatectomy and age varies according to the evolution of urodynamics. There was a significant reduction in terms of residual urine volume and detrusor pressure with a normal desire to void in patients without a prostatectomy and in those under 75 years old. In addition to an increase in urge incontinence, there was also a significant worsening of the bladder filling urodynamics and a decrease in the cystomanometric bladder capacity with a strong desire and an urge to void. None of these were modified by age or prostatectomy (AU)

Impact of a radical prostatectomy on the urodynamic results of prostate cancer patients treated with intensity modulated radiation therapy.

INTRODUCTION AND OBJECTIVES: To evaluate the effect of radical prostatectomy and age on urodynamics before and after intensity-modulated radiation therapy administered to prostate cancer patients. MATERIALS AND METHODS: The sample consisted of 40 prostate cancer patients, 22 of whom had undergone a radical prostatectomy. Urodynamic parameters before and after an average of 4.2 months of radiotherapy were measured and compared. External radiotherapy was administered via Volumetric Modulated Arc Therapy (VMAT), Intensity Modulated Radiation Therapy (IMRT) techniques. RESULTS: Uroflowmetry presented no significant parameters. In the case of Cystomanometry, the data did not show an increase in secondary stress urinary incontinence, although there is 7 percent increase in urge urinary incontinence. There were statistically significant changes in reduced bladder capacity with a strong desire to void, with an urge to void and also in the detrusor pressure with a normal desire to void. Furthermore, pressure/flow analysis revealed a statistically significant reduction of residual urine volume. CONCLUSIONS: The effect of prostatectomy and age varies according to the evolution of urodynamics. There was a significant reduction in terms of residual urine volume and detrusor pressure with a normal desire to void in patients without a prostatectomy and in those under 75 years old. In addition to an increase in urge incontinence, there was also a significant worsening of the bladder filling urodynamics and a decrease in the cystomanometric bladder capacity with a strong desire and an urge to void. None of these were modified by age or prostatectomy.