1206 PRE-OPERATIVE URINARY AND ERECTILE FUNCTION REPRESENT SIGNIFICANT PREDICTORS OF POST-OPERATIVE URINARY CONTINENCE RECOVERY IN PATIENTS TREATED WITH NERVE SPARING RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Evaluation1 Apr 20101206 PRE-OPERATIVE URINARY AND ERECTILE FUNCTION REPRESENT SIGNIFICANT PREDICTORS OF POST-OPERATIVE URINARY CONTINENCE RECOVERY IN PATIENTS TREATED WITH NERVE SPARING RADICAL PROSTATECTOMY Andrea Gallina, Alberto Briganti, Luigi Barbieri, Andrea Salonia, Renzo Colombo, Francesco Sozzi, Zanni Giuseppe, Federico Pellucchi, Valerio Di Girolamo, Patrizio Rigatti, and Francesco Montorsi Andrea GallinaAndrea Gallina More articles by this author , Alberto BrigantiAlberto Briganti More articles by this author , Luigi BarbieriLuigi Barbieri More articles by this author , Andrea SaloniaAndrea Salonia More articles by this author , Renzo ColomboRenzo Colombo More articles by this author , Francesco SozziFrancesco Sozzi More articles by this author , Zanni GiuseppeZanni Giuseppe More articles by this author , Federico PellucchiFederico Pellucchi More articles by this author , Valerio Di GirolamoValerio Di Girolamo More articles by this author , Patrizio RigattiPatrizio Rigatti More articles by this author , and Francesco MontorsiFrancesco Montorsi More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.708AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Pre-op erectile function (EF) represents an important determinant of EF recovery after bilateral nerve sparing radical prostatectomy (BNSRP). However, poor data is available on the association between baseline EF or urinary function and urinary continence (UC) recovery after BNSRP. The aim of this study was to address the association between pre-op functional data and post-operative UC recovery in patients treated with BNSRP METHODS The study included 752 patients treated with BNSRP at a single tertiary referral center between June 2003 and June 2009. All patients had complete pre-op data including pre-op EF assessed by the International Index of Erectile Function (IIEF-EF) and urinary function evaluated with the International Prostatic Symptoms score (IPSS). All patients post-op completed the International Consultation on Incontinence questionnaire (ICIQ) every 3 months during the first year after surgery and every 6 months thereafter. UC recovery was defined as an ICIQ score ≤6 (no pads). Univariable and multivariable Cox regression models addressed the rates of UC. Covariates consisted of pre-op EF and urinary function, age, body mass index (BMI), pathological stage and pre-op PSA RESULTS Mean and median age at surgery was 62.4 and 62.5 yrs, respectively. Pre-op IIEF-EF showed severe, moderate, mild to moderate, mild and no ED in 23.6, 6.2, 6.2, 17.4 and 46.6% of patients, respectively. IPSS scores were 0-7 (no/mild symptoms), 8-19 (moderate), ≥ 20 (severe) in 49.4, 39.8 and 10.8%, respectively. Mean and median BMI was 25.8 and 25.6 kg/m2, respectively. At univariable Cox regression analyses, patient age, pre-op IIEF-EF and IPSS scores were significantly associated with UC after surgery (all p'0.002). These data were confirmed at multivariable analyses, where age and pre-op IPSS scores maintained their significant inverse association with UC recovery while IIEF-EF domain showed a significant direct association with UC after BNSRP (all p≤0.04). Patients with full EF prior to surgery (≥26) had a 1.5 higher probability of UC recovery as compared to patients with severe ED, even after accounting for the effects of the other predictors (p=0.02) CONCLUSIONS We demonstrated that pre-op EF and urinary functions represent significant predictors of UC after surgery. We speculate that pre-op ED might be a marker of pelvic vascular disease which may affect the external urinary sphincter. Pre-op functional parameters should be also considered for UC prediction after BNSRP Milan, Italy© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e467 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andrea Gallina More articles by this author Alberto Briganti More articles by this author Luigi Barbieri More articles by this author Andrea Salonia More articles by this author Renzo Colombo More articles by this author Francesco Sozzi More articles by this author Zanni Giuseppe More articles by this author Federico Pellucchi More articles by this author Valerio Di Girolamo More articles by this author Patrizio Rigatti More articles by this author Francesco Montorsi More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...