MP51-07 ANATOMICAL CHANGE RELATED TO PERSISTENT INCONTINENCE FOLLOWING RADICAL PROSTATECTOMY: EVALUATION USING PREOPERATIVE AND POSTOPERATIVE MAGNETIC RESONANCE IMAGE

Abstract

You have accessJournal of UrologyProstate Cancer: Localized V1 Apr 2014MP51-07 ANATOMICAL CHANGE RELATED TO PERSISTENT INCONTINENCE FOLLOWING RADICAL PROSTATECTOMY: EVALUATION USING PREOPERATIVE AND POSTOPERATIVE MAGNETIC RESONANCE IMAGE Woo Suk Choi, Hwanik Kim, Jun-Gyo Suh, Ja Hyeon Ku, Sang Youn Kim, Jeong Yeon Cho, Soo Woong Kim, Hyeon Hoe Kim, Jae-Seung Paick, Seung Hyup Kim, and Cheol Kwak Woo Suk ChoiWoo Suk Choi More articles by this author , Hwanik KimHwanik Kim More articles by this author , Jun-Gyo SuhJun-Gyo Suh More articles by this author , Ja Hyeon KuJa Hyeon Ku More articles by this author , Sang Youn KimSang Youn Kim More articles by this author , Jeong Yeon ChoJeong Yeon Cho More articles by this author , Soo Woong KimSoo Woong Kim More articles by this author , Hyeon Hoe KimHyeon Hoe Kim More articles by this author , Jae-Seung PaickJae-Seung Paick More articles by this author , Seung Hyup KimSeung Hyup Kim More articles by this author , and Cheol KwakCheol Kwak More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1663AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives We evaluated anatomical change that is related to incontinence after radical prostatectomy (RP) in the patients with prostate cancer, using magnetic resonance image (MRI). Methods We performed MRI at preoperative and postoperative 12 months to the patients who underwent RP between November, 2011 and March 2013. Preoperative membranous urethral length (pre-MUL), postoperative MUL (post-MUL), and postoperative thickness of anterior peri-urethral structure (post-APUS) were measured in the midline sagittal plane on T2-weighted MR images, respectively (Figure 1). Persistent incontinence was defined by using ≥ 1 pad (Pad 1), and persistent severe incontinence was defined by using ≥ 2 pads (Pad 2) at postoperative 12 months. Results The mean age of 245 patients were 66.4 ± 7.0 years. Open and robotic RP were performed on 128 (52.2%) and 117 (47.8%) patients. Patients in group Pad 1 and 2 were 50 (20.4%) and 11 (4.5%), respectively. On the ROC curve analysis, optimal cut-off values of pre-MUL, post-MUL, and post-APUS that could predict incontinence were <14.5mm, <10.5mm, and <3.0mm. On univariate analysis, factors related to Pad 1 were post-MUL (<10.5mm), an amount of decrease in MUL (>4.0mm), prostate volume (>45cc), clinical stage (≥cT2), and ASA score (≥2), and factors related to Pad 2 were post-MUL, an amount of decrease in MUL, post-APUS (<3.0mm), prostate volume, hypertension, and pathologic stage (pT3). On multivariate analysis, factors that influence on Pad 1 were post-MUL (OR=12.1, 95%CI=4.7-31.5) and clinical stage (OR=3.8, 95%CI=1.1-13.8), and variables that were related to Pad 2 were post-MUL (OR=16.4, 95%CI=3.8-71.8), post-APUS (OR=5.8, 95%CI=1.4-23.7), and pathologic stage (OR=6.2 95%CI=1.4-27.4). Although the patients have pre-MUL <14.5mm, Pad 1 and Pad 2 occurred only in 13.3% and 2.4%, respectively when post-MUL was preserved (≥10.5mm). In contrast, the occurrence of Pad 1 and Pad2 was 60.0% and 20.0%, respectively without preserved post-MUL. Conclusions Preserving MUL is important for preventing persistent incontinence, regardless of pre-MUL. In addition, saving APUS can help prevent the occurrence of severe persistent incontinence. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e599-e600 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Woo Suk Choi More articles by this author Hwanik Kim More articles by this author Jun-Gyo Suh More articles by this author Ja Hyeon Ku More articles by this author Sang Youn Kim More articles by this author Jeong Yeon Cho More articles by this author Soo Woong Kim More articles by this author Hyeon Hoe Kim More articles by this author Jae-Seung Paick More articles by this author Seung Hyup Kim More articles by this author Cheol Kwak More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...