DETRUSOR UNDERACTIVITY AFTER RADICAL PROSTATECTOMY: A RETROSPECTIVE ANALYSIS

INTRODUCTION AND AIM OF THE STUDY: Detrusor Underactivity (DU) is de\ufb01ned , according to ICS, as \u2018\u2018a contraction of reduced strength and/or duration, resulting in prolonged bladder emptying and/or failure to achieve complete bladder emptying within a normal time span\u2019\u2019. It is a common urodynamic observation in patients (pts) presenting for evaluation of urinary incontinence and/or lower urinary tract symptoms (LUTS) following radical prostatectomy (RP) . In the literature its prevalence varied from 29% to 61%, and it was \u2018\u2018de novo\u2019\u2019 in 47% of pts (1); according to other Authors, DU was even more frequent after RP (2). Detrusor denervation at surgery is a plausible explanation for DU, but many other factors may contribute to its occurrence. The aim of the study was to evaluate the prevalence of DU in pts who underwent RP and to correlate it with demographic, clinical and other urodynamic variables. MATERIALS AND METHODS: The urodynamic traces and reports of 77 consecutive pts were retrospectively evaluated. Studies on pts with arti\ufb01cial urinary sphincter (AUS) and duplicate studies on a single patient were excluded. The mean age of the pts studied was 69.73 years (range 57\u201381). The indications for urodynamics were mainly stress or mixed urinary incontinence, often associated with voiding symptoms. DU was de\ufb01ned by Bladder Contractility Index (BCI ) 70 yrs (P = 0.033); abdominal voiding in 6 pts; no voiding and minimal/not sustained detrusor contraction in 2 pts. INTERPRETATION OF RESULTS: The present study con\ufb01rmed the high prevalence of the voiding dysfunction following RP. The most frequent urodynamic observation was USI, followed by DO, as expected: in fact, the population studied was selected and mostly included pts with urinary incontinence. Also, the prevalence of DU was high (64.9%), similar to that found by other Authors (2). Statistically, the only parameter signi\ufb01cantly correlated with DU was the advanced age ( >70 yrs). CONCLUSIONS: DU is an important part of the complex of lower urinary tract dysfunction occurring after radical prostatectomy. It needs to be well-studied in order to precise its real incidence and pathophysiology, still unclear. The clinical importance of this urodynamic observation in pts who underwent RP is important not only in pts with voiding problems and/or urinary retention, but also in incontinent pts who are potential candidates for sling placement

Disease-specific and general health-related quality of life in newly diagnosed prostate cancer patients: The Pros-IT CNR study

BACKGROUND: The National Research Council (CNR) prostate cancer monitoring project in Italy (Pros-IT CNR) is an observational, prospective, ongoing, multicentre study aiming to monitor a sample of Italian males diagnosed as new cases of prostate cancer. The present study aims to present data on the quality of life at time prostate cancer is diagnosed. METHODS: One thousand seven hundred five patients were enrolled. Quality of life is evaluated at the time cancer was diagnosed and at subsequent assessments via the Italian version of the University of California Los Angeles-Prostate Cancer Index (UCLA-PCI) and the Short Form Health Survey (SF-12). RESULTS: At diagnosis, lower scores on the physical component of the SF-12 were associated to older ages, obesity and the presence of 3+ moderate/severe comorbidities. Lower scores on the mental component were associated to younger ages, the presence of 3+ moderate/severe comorbidities and a T-score higher than one. Urinary and bowel functions according to UCLA-PCI were generally good. Almost 5% of the sample reported using at least one safety pad daily to control urinary loss; less than 3% reported moderate/severe problems attributable to bowel functions, and sexual function was a moderate/severe problem for 26.7%. Diabetes, 3+ moderate/severe comorbidities, T2 or T3-T4 categories and a Gleason score of eight or more were significantly associated with lower sexual function scores at diagnosis. CONCLUSIONS: Data collected by the Pros-IT CNR study have clarified the baseline status of newly diagnosed prostate cancer patients. A comprehensive assessment of quality of life will allow to objectively evaluate outcomes of different profile of care

Disease-specific and general health-related quality of life in newly diagnosed prostate cancer patients: the Pros-IT CNR study

Background: The National Research Council (CNR) prostate cancer monitoring project in Italy (Pros-IT CNR) is an observational, prospective, ongoing, multicentre study aiming to monitor a sample of Italian males diagnosed as new cases of prostate cancer. The present study aims to present data on the quality of life at time prostate cancer is diagnosed. Methods: One thousand seven hundred five patients were enrolled. Quality of life is evaluated at the time cancer was diagnosed and at subsequent assessments via the Italian version of the University of California Los Angeles-Prostate Cancer Index (UCLA-PCI) and the Short Form Health Survey (SF-12). Results: At diagnosis, lower scores on the physical component of the SF-12 were associated to older ages, obesity and the presence of 3+ moderate/severe comorbidities. Lower scores on the mental component were associated to younger ages, the presence of 3+ moderate/severe comorbidities and a T-score higher than one. Urinary and bowel functions according to UCLA-PCI were generally good. Almost 5% of the sample reported using at least one safety pad daily to control urinary loss; less than 3% reported moderate/severe problems attributable to bowel functions, and sexual function was a moderate/severe problem for 26.7%. Diabetes, 3+ moderate/severe comorbidities, T2 or T3-T4 categories and a Gleason score of eight or more were significantly associated with lower sexual function scores at diagnosis. Conclusions: Data collected by the Pros-IT CNR study have clarified the baseline status of newly diagnosed prostate cancer patients. A comprehensive assessment of quality of life will allow to objectively evaluate outcomes of different profile of care

Urology in the time of coronavirus: reduced access to urgent and emergent urological care during the coronavirus disease 2019 outbreak in Italy

The coronavirus disease 2019 (COVID-19) pandemic has put a substantial burden on the Italian healthcare system, resulting in the restructuring of hospitals to care for COVID-19 patients. However, this has likely impacted access to care for patients experiencing other conditions. We aimed to quantify the impact of COVID-19 on access to care for patients with urgent/emergent urological conditions throughout Italy

Pros-IT CNR: an Italian prostate cancer monitoring project

Aims: The Pros-IT CNR project aims to monitor a sample of Italian males \ue2\u89\ua518\uc2 years of age who have been diagnosed in the participating centers with incident prostate cancer, by analyzing their clinical features, treatment protocols and outcome results in relation to quality of life. Methods: Pros-IT CNR is an observational, prospective, multicenter study. The National Research Council (CNR), Neuroscience Institute, Aging Branch (Padua) is the promoting center. Ninety-seven Italian centers located throughout Italy were involved. The field study began in September 1, 2014. Subjects eligible were diagnosed with biopsy-verified prostate cancer, na\uc3\uafve. A sample size of 1500 patients was contemplated. A baseline assessment including anamnestic data, clinical history, risk factors, the initial diagnosis, cancer staging information and quality of life (Italian UCLA Prostate Cancer Index; SF-12 Scale) was completed. Six months after the initial diagnosis, a second assessment evaluating the patient\ue2\u80\u99s health status, the treatment carried out, and the quality of life will be made. A third assessment, evaluating the treatment follow-up and the quality of life, will be made 12\uc2 months after the initial diagnosis. The 4th, 5th, 6th and 7th assessments, similar to the third, will be completed 24, 36, 48 and 60\uc2 months after the initial diagnosis, respectively, and will include also a Food Frequency Questionnaire and the Physical Activity Scale for the Elderly. Discussion: The study will provide information on patients\ue2\u80\u99 quality of life and its variations over time in relation to the treatments received for the prostate cancer