Login to Access Video or Poster Abstract: MP31-09
Sources of Funding: none

Introduction

To elucidate the etiology of lower urinary tract symptoms (LUTS) after radical prostatectomy (RP), the present study investigated association between postoperative urethral and vesical anatomical features on magnetic resonance imaging (MRI) and LUTS.

Methods

Fifty-three consecutive patients undergoing RP also underwent pre- and postoperative MRI. Preoperative MRI only evaluated preoperative membranous urethral length (MUL). Postoperative MRI evaluated postoperative MUL, posterior-urethral vesical angle, depth of the urethrovesical junction (UVJ), and urinary pooling inside the urethra and bladder neck configuration (Figure 1 and 2). At the same time as postoperative MRI, International Prostate Symptom Score (IPSS), quality of life (QOL) index, continence grade, and uroflowmetry was investigated. Associations between pre- or postoperative MRI variables and questionnaire results or uroflowmetry were analyzed to examine the relationship between morphology of the urethral and vesical anatomical features and LUTS.

Results

Pre- and postoperative MRI variables were not significantly associated with parameters of IPSS total score and uroflowmetry. Urinary pooling inside the urethra was significantly associated with the urgency score in IPSS (p=0.006). Postoperative MUL (p<0.001), depth of UVJ (p=0.002) and urinary pooling inside the urethra (p=0.04) were significantly associated with continence grade.

Conclusions

Urinary pooling inside the urethra might induce urgency, and postoperative MUL and depth of UVJ were related to urinary incontinence. Avoiding damage to the continence nerve to prevent inflow of urine into the urethra, preserving the MUL, and developing procedures to prevent declines in the bladder neck during surgery are therefore recommended._x000D_ _x000D_

Funding

none