Ervandian Maria, Djurhuus Jens Christian, Høyer Morten, Graugaard-Jensen Charlotte, Borre Michael
a Department of Urology , Aarhus University Hospital , Aarhus , Denmark.
b Department of Clinical Medicine , Aarhus University Hospital , Aarhus , Denmark.
Scand J Urol. 2018 Feb;52(1):20-26. doi: 10.1080/21681805.2017.1354067. Epub 2017 Jul 27.
Lower urinary tract symptoms (LUTS) are common following radical prostatectomy (RP) or intended curative radiotherapy in prostate cancer patients. One-quarter of those treated with RP experience biochemical failure and are subsequently offered salvage radiotherapy (SRT) to the prostatic bed. The aim of this study was to elucidate long-term LUTS after surgery and SRT.
Urodynamic parameters from 16 patients treated with RP and subsequent SRT in the period 2000-2010 were evaluated with uroflowmetry, filling cystometry, pressure-flow and urethral pressure profile (UPP). In conjunction with the urodynamic examination, all patients completed the Danish Prostatic Symptom Score (DAN-PSS) questionnaire, which evaluates the grade of LUTS.
Median time from SRT to urodynamic examination was 7.7 years (range 5.8-10.0 years). The following urodynamic parameters were affected: bladder volume at maximal cystometric capacity, bladder compliance, bladder function, bladder outlet obstruction and UPP. The total DAN-PSS index combining all symptoms and their corresponding impact on patients was mild in six patients (≤ 7 points), moderate in seven patients (8-19 points) and severe in three patients (≥ 20 points).
This urodynamic study is one of the first to evaluate long-term urodynamic characteristics in patients treated with SRT. Several urodynamic parameters were affected. This indicates that SRT primarily affects bladder compliance, maximal cystometric capacity and bladder outlet obstruction. LUTS were proven to be strongly related to urodynamic parameters.
下尿路症状（LUTS）在前列腺癌患者接受根治性前列腺切除术（RP）或根治性放疗后很常见。接受RP治疗的患者中有四分之一会出现生化失败，随后会接受前列腺床挽救性放疗（SRT）。本研究的目的是阐明手术和SRT后的长期LUTS情况。
对2000年至2010年期间接受RP及后续SRT治疗的16例患者的尿动力学参数进行了评估，包括尿流率测定、充盈性膀胱测压、压力-流率测定和尿道压力分布（UPP）。在进行尿动力学检查的同时，所有患者均完成了丹麦前列腺症状评分（DAN-PSS）问卷，该问卷用于评估LUTS的严重程度。
从SRT到尿动力学检查的中位时间为7.7年（范围为5.8 - 10.0年）。以下尿动力学参数受到影响：最大膀胱测压容量时的膀胱容积、膀胱顺应性、膀胱功能、膀胱出口梗阻和UPP。综合所有症状及其对患者相应影响的DAN-PSS总指数，6例患者为轻度（≤7分），7例患者为中度（8 - 19分），3例患者为重度（≥20分）。
这项尿动力学研究是首批评估接受SRT治疗患者长期尿动力学特征的研究之一。多个尿动力学参数受到影响。这表明SRT主要影响膀胱顺应性、最大膀胱测压容量和膀胱出口梗阻。LUTS被证明与尿动力学参数密切相关。
