Impact of Intravesical Prostatic Protrusion on Continence Outcomes after Robotic-Assisted Laparoscopic Radical Prostatectomy

Abstract

Purpose: We try to evaluate the influence of intravesical prostatic protrusion (IPP) in the postoperative continence of patient who received robotic assisted laparoscopic radical prostatectomy. Methods: A total 600 patients who underwent robotic assisted laparoscopic radical prostatectomy were included in the study. Preoperative MRI was performed in all patients and the vertical distance from the tip of the protruding prostate to the base of the urinary bladder was measured in all sagittal plane. The degree of intravesical prostatic protrusion were divided into three groups (IPP<5 mm, 5 mm<IPP<10 mm, 10 mm<IPP). Surgical procedure was mentioned. Continence was defined as no pad use or only one safety pad per day and assessed at 1, 3 and 12 months postoperatively. The result was examined. Results: The overall continence rate at 1, 3 and 12 month was 69.2%, 91.33% and 95.5%. Among the three groups, there is significant difference in 1 month, 3 months and 12 months continence rate (IPP<5 mm: 82.5%, 96.3%, 97.7%; 5 mm<IPP<10 mm: 61.9%, 89.4%, 94.4%; 10 mm<IPP: 30%, 75.6%, 88.9%, p<0.001). At first month, 415 patients achieved continence but 195 patients still incontinence and the length of IPP among the two groups were 4.43 mm ± 3.74 mm and 8.69 mm ± 6.63 mm, p<0.001. There is also significant difference in IPP length among continence and incontinence group. Conclusions: To our result, both of intravesical prostatic protrusion and prostate volume was correlated with recovery of early and one year continence after robotic assisted laparoscopic radical prostatectomy and with inferior outcome.