Abstract
PurposeWe investigated that preoperative membranous urethral length (MUL) would be associated with the recovery of urinary continence after robot-assisted laparoscopic prostatectomy (RALP).Patients and methodsWe studied 204 patients who underwent RALP between May 2013 and March 2016. All patients underwent pelvic magnetic resonance imaging (MRI) preoperatively to measure MUL. Urinary continence was defined as the use of one pad or less (safety pad). The 204 patients were divided into two groups: continence group, those who achieved recovery of continence at 3, 6, and 12 months after RALP, and incontinence group, those who did not. We retrospectively analyzed the patients in terms of preoperative clinical factors including age, body mass index (BMI), estimated prostate volume, neurovascular bundle salvage, history of preoperative hormonal therapy, and MUL.ResultsThe safety pad use rate was 69.6%, 86.9%, and 91.1% at 3, 6, and 12 months, respectively. On univariate and multivariate analyses, MUL were significant factors in every term of recovery of urinary continence in both groups. According to the receiver operating characteristic (ROC) curve analysis, the preoperative MUL that could best predict early recovery of urinary continence at 3 months after RALP was 12 mm.ConclusionsWe suggest that preoperative MUL > 12 mm would be a predictor of early recovery of urinary continence after RALP.
Highlights
Urinary incontinence is one of the most unfavorable complications influencing the quality of life for patients after radical prostatectomy (RP)
We suggest that preoperative Membranous urethral length (MUL) > 12 mm would be a predictor of early recovery of urinary continence after robot-assisted laparoscopic prostatectomy (RALP)
We evaluated the association of preoperative MUL with the recovery of urinary incontinence after RALP in Japanese patients
Summary
We performed RALP using the da Vinci Si surgical system in 204 consecutive patients from whom we could collect the Expanded Prostate Cancer Index Composite (EPIC) questionnaire [5] at least preoperatively and 3 months after RALP between May 2013 and March 2016. Urinary continence was evaluated at 3, 6, and 12 months after RALP using question 5 of the EPIC questionnaire [5]. Univariate analysis was performed with the t test, analysis of variance, chi-square, and Fisher’s exact test between continence and incontinence group regarding preoperative clinical factors including patient age, BMI, estimated prostate volume, clinical stage, neurovascular bundle salvage, history of preoperative hormonal therapy, positive surgical margin, leakage at vesicourethral anastomosis, and MUL. Differences with P < 0.05 were considered statistically significant
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