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IMPACT OF SOLIFENACIN ONCE A DAY ON BLADDER FUNCTION IN PATIENTS
SUBMITTED TO OPEN RETROPUBIC RADICAL PROSTATECTOMY FOR LOCALIZED
PROSTATE CANCER
Introduction & Objectives
Urinary incontinence (UI) is one of the most devastating complication following open retropubic radical
prostatectomy (RRP). The possible causes include urethral sphincter deficiency and detrusor overactivity
To assess the impact of anticholinergic drug solifenacin, on urinary continence, quality of life and bladder
function of patients (pts) submitted to RRP for localized prostate cancer.
Materials and Methods
One hundred and twenty consecutive pts with localised prostate cancer and submitted to RRP were included
and randomly divided into 3 groups (Group 1, Group 2 and Group 3). RRP was performed by a high-volume
surgeons with nerve sparing and bladder neck preserving techniques based on clinical stage, cancer location
and patient age. Pts in group 1 (n=22) received solifenacina 5 mg daily for 3 months; pts in group 2 (n=20)
received solifencina 10 mg daily for 3 months; pts in group 3 (n=78) did not received any treatment. Pts were
administered International Prostate Index Score, Quality of Life SF-36 questionnaire, Quality of Life due to
urinary problems and the OAB awareness tool questionnaire before RRP, at the one month follow-up after
removal of the urethral catheter and at the end of the 3-month of pharmacologic treatment with solifenacin.
The number of pads used by patients at the same follow-up dates had also been detailed.
Results
The mean age was 63.4 years (range 50-74) in group 1, 64 years (range 39-74) in group 2 and 65 years
(range 41-84) in group 3. Mean pre-operative IPSS score, OAB score and OAB awarness tool score was 8.6;
51 and 8.3 in group 1; 9.2; 63.3 and 13.4 in group 2; 10.7; 52.7 and 10.4 in group 3. SF-36 questionnaire
showed homogeneous score in three groups (overall mean Health domain score was 67.8; 59.2 and 70.8 in
group 1,2 and 3, respectively). In each group, one month post-operative mean IPSS score and OAB score
showed a statistically significant increase (mean IPSS score of 11,8; 14,8 and 16,2 respectively in group 1, 2
and 3; mean OAB awareness tool score 15; 17,1; 18,2 respectively into group 1, 2 and 3). Three month postoperative mean IPSS score was significantly better compared to preoperative in group 1 (p<0.001) as well as
mean OAB awareness tool score (p<0.001) and OAB score (p<0.001).
Discussion
Despite improvements in surgical techniques, UI is not uncommon after RRP, and it may dramatically
worsen quality of life. Bladder dysfunction after RRP may be represented also by involuntary detrusor
contractions, impaired bladder filling sensation, low bladder compliance, and impaired detrusor contractility.
Our data show a high incidence of OAB in patients undergoing RRP, which may negatively affect the
quality of life.
Conclusions
Solifenacina may have a role in improving symptoms and quality of life in the early postoperative months
after RRP. Further randomized placebo-controlled study may be necessary to define the role of
anticholinergic drug in pts subjected to RRP.