Anorectal function and symptoms 6 months after robot-assisted laparoscopic radical prostatectomy: a single-center study

Theodoros Psarias; Susanna Walter; Martin Holmbom; Issa Khayoun Issa; Firas Abdul-Sattar Aljabery; Olof Hallböök

doi:10.2340/sju.v59.35396

Authors

Theodoros Psarias Department of Clinical and Experimental Medicine, Division of Urology, Linköping University, Linköping, Sweden
Susanna Walter Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
Martin Holmbom Department of Clinical and Experimental Medicine, Division of Urology, Linköping University, Linköping, Sweden
Issa Khayoun Issa Department of Clinical and Experimental Medicine, Division of Urology, Linköping University, Linköping, Sweden
Firas Abdul-Sattar Aljabery Department of Clinical and Experimental Medicine, Division of Urology, Linköping University, Linköping, Sweden
Olof Hallböök Department of Biomedical and Clinical Sciences, Division of Surgery, Linköping University, Linköping, Sweden

DOI:

https://doi.org/10.2340/sju.v59.35396

Keywords:

RALP, Prostatectomy, fecal incontinence, bowel, anorectal function

Abstract

Introduction: Robot-assisted laparoscopic radical prostatectomy (RALP) is a common procedure for the treatment of localised prostate cancer. Anorectal symptoms such as fecal incontinence (FI), rectal urgency or disturbed defecation have been reported after the operation. Anorectal function is dependent on the integrity of anal and pelvic nerves and muscles, rectal sensory function as well as rectal reservoir function.

The aim of this study was to investigate the potential influence of RALP on anorectal physiological function and bowel symptoms.

Materials and Methods: In this pilot study, 29 patients with localised prostate cancer scheduled for RALP were included. Anorectal physiology was used to measure rectal sensitivity and reservoir function as well as anal sphincter pressures. Bowel symptoms were measured by a bowel function questionnaire and a 2-week bowel function diary. Measurements were done before the operation and repeated at 6 months after the operation.

Results: The study observed a significant postoperative increase in rectal sensory threshold for rectal balloon distention, from 20 to 40 mmHg, P < 0.001. This change is indicative of a decrease in rectal sensation after RALP. There were no other statistical significant differences in any of the physiological tests performed. Importantly, there was no change in any of the bowel symptoms after surgery.

Conclusion: This study showed that RALP may lead to impaired rectal sensory function. This finding did not, however, seem to have any influence on the patients´ postoperative clinical bowel function.

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