Urologic problems constitute the most frequent and troublesome complications following APR. Urinary dysfunction was observed in 23 cases. While bladder neck or prostate angulations may be contributory, the majority of micturition disturbances are due to neurologic injury. As voiding dysfunction after APR is common and transitory, one can expect it to subside within three to six months post-operatively.
Fowler and coworkers warned that if large volume retention in the post-operative period secondary to bladder denervation is not recognised and remains untreated, bladder rehabilitation and restoration of normal voiding may be impossible. Many Authors advocate the use of urodynamic studies in order to identify patients at risk of developing urologic problems and to detect early post-operative voiding dysfunction.
Urinary dysfunction was of particular interest in the evaluation of the nerve-preserving procedure effectiveness.
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