MP19-13 THE ANTERIOR URETHROVESCIAL ANGLE MEASURED ON POSTOPERATIVE CYSTOGRAPHY CAN PREDICT URINARY INCONTINENCE AFTER ROBOT-ASSISTED LAPAROSCOPIC RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy I (MP19)1 Apr 2020MP19-13 THE ANTERIOR URETHROVESCIAL ANGLE MEASURED ON POSTOPERATIVE CYSTOGRAPHY CAN PREDICT URINARY INCONTINENCE AFTER ROBOT-ASSISTED LAPAROSCOPIC RADICAL PROSTATECTOMY Feifei Zhang*, Xuefeng Qiu, and Hongqian Guo Feifei Zhang*Feifei Zhang* More articles by this author , Xuefeng QiuXuefeng Qiu More articles by this author , and Hongqian GuoHongqian Guo More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000852.013AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Robot-assisted laparoscopic radical prostatectomy (RALP) is associated with urinary incontinence. We evaluated early urinary continence in a set of consecutive patients who underwent conventional RALP (CON-RALP) and Retzius-sparing robot-assisted laparoscopic radical prostatectomy (RS-RALP) to identify the useful predictors of postoperative urinary incontinence as determined by postoperative cystography. METHODS: The study consisted of 121 patients who underwent CON-RALP (n=61) and RS-RALP (n=60). Postoperative cystography was performed within7-10 days after RALP. The ratio between the horizontal and longitudinal length (H/L) of the bladder, the position of the urethrovesical junction (UVJ) quantitatively calculated by bladder neck to pubic symphysis(BNPS) ratio, the anterior urethrovesical angle (aUVA), posterior urethrovesical angle (pUVA) as seen on the cystogram were evaluated. Postoperative continence status was defined by no pad or a safety pad usage after catheter removal. The association between these vairables and urinary incontinence was then analyzed. All patients were followed for at least 3 months postoperatively. RESULTS: The demographic, intraoperative data and postoperative pathologic-related information showed no significant difference. The aUVA, pUVA and H/L ratio showed statistical significance. The continence recovery rates differed significantly at 2 weeks, 1 and 2 months. On univariate analysis, patients’ age was independent risk predictor of urinary incontinence. On multivariate analysis, urinary incontinence was significantly associated with H/L ratio, nerve-sparing technique at 2 weeks. At 1 month, the urinary continence was significantly correlated with age, nerve-sparing technique, aUVA. The independent risk factors at 2 month included age, nerve-sparing technique, aUVA, BNPS ratio. The multivariate logistic regression analysis just showed aUVA was related to the urinary incontinence at 3 months postoperatively. CONCLUSIONS: RS-RARP facilitate the recovery of early urinary continence after surgery. A larger aUVA measured on postoperative cystography is a useful and independent predictor for short-term urinary incontinence after RALP. Advanced age, nerve-sparing technique, larger aUVA, larger BNPS ratio, lesser H/L ratio will increase the risk of early urinary incontinence. Source of Funding: the National Natural Science Foundation of China (81772710, 81572519, 81602232) © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e303-e303 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Feifei Zhang* More articles by this author Xuefeng Qiu More articles by this author Hongqian Guo More articles by this author Expand All Advertisement PDF downloadLoading ...