MP46-02 RADICAL PROSTATECTOMY AND RECOVERY OF URINARY CONTINENCE IN PATIENTS WITH LOCALLY ADVANCED PROSTATE CANCER

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Male Incontinence: Therapy1 Apr 2017MP46-02 RADICAL PROSTATECTOMY AND RECOVERY OF URINARY CONTINENCE IN PATIENTS WITH LOCALLY ADVANCED PROSTATE CANCER Jung Keun Lee, In Jae Lee, Tae Jin Kim, Hakmin Lee, Jong Jin Oh, Sangchul Lee, Jeong Hyun Kim, Sung Kyu Hong, Seok-Soo Byun, Sang Eun Lee, and Seong Jin Jeong Jung Keun LeeJung Keun Lee More articles by this author , In Jae LeeIn Jae Lee More articles by this author , Tae Jin KimTae Jin Kim More articles by this author , Hakmin LeeHakmin Lee More articles by this author , Jong Jin OhJong Jin Oh More articles by this author , Sangchul LeeSangchul Lee More articles by this author , Jeong Hyun KimJeong Hyun Kim More articles by this author , Sung Kyu HongSung Kyu Hong More articles by this author , Seok-Soo ByunSeok-Soo Byun More articles by this author , Sang Eun LeeSang Eun Lee More articles by this author , and Seong Jin JeongSeong Jin Jeong More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1441AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Few studies have been reported on the evaluation for recovery of urinary continence after radical prostatectomy in patients with locally advanced prostate cancer. We conducted a study of ≥pT3 patients to improve understanding of the natural history of continence state and to identify predictors useful in patient selection for incontinence management. METHODS We reviewed the data ofpatientswith prostate cancer managed by open retropubicor robotic radical prostatectomyfrom January 2004 to May 2015. Excluding patients requesting short-term follow-up (< 12 months), 1,859 subjects were eligible for the study. Achievement of continence was defined as no pads or an occasional security pad. A total of 547 patients were diagnosed ≥pT3 disease. Multivariate logistic regression analyses were used to determine predictors for early continence (recovery within 3 months) or for persistent incontinence (no recovery after 12 months). Furthermore, ≤ pT2 patients were matched 1:1 to ≥pT3 patients based on the propensity score. Predictors of recovery of urinary continence were compared between ≥pT3 and ≤ pT2 patients. RESULTS Of the 547 patients with ≥pT3, 63% underwent robotic surgery and 42%received bilateral nerve sparing procedure. Continence recovery at 1 month, 3 months, 6 months, 9 months, and 12 months was observed in 27%, 76%, 89%, 92%, and 95% of patients, respectively. Age (OR 0.967, p = 0.045), membranous urethra length (OR 1.120, p = 0.004), and bilateral nerve saving (OR 1.956, p = 0.006) had the significant predictive value for early continence. Additionally, open surgery (vs. robotic) was an independent risk factor for persistent incontinence (OR 3.146, p = 0.002). Of the ≤ pT2 patients, age, membranous urethra length, and bilateral nerve saving were also statistically associated with early continence recovery. However, open surgery did not show a significance to predict persistent incontinence (OR 0.656, p = 0.305) (table). CONCLUSIONS Urinary continence was achieved in most patients with ≥pT3 prostate cancer managed by radical prostatectomy. Our results highlight the advantage of robotic surgery for continence outcomes in patients with ≥pT3 prostate cancer compared with ≤ pT2. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e619 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Jung Keun Lee More articles by this author In Jae Lee More articles by this author Tae Jin Kim More articles by this author Hakmin Lee More articles by this author Jong Jin Oh More articles by this author Sangchul Lee More articles by this author Jeong Hyun Kim More articles by this author Sung Kyu Hong More articles by this author Seok-Soo Byun More articles by this author Sang Eun Lee More articles by this author Seong Jin Jeong More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...