MP59-12 CAN ANATOMICAL MEASUREMENTS ON PREOPERATIVE PELVIC MAGNETIC RESONANCE IMAGING PREDICT POSTOPERATIVE URINARY INCONTINENCE AFTER HOLMIUM LASER ENUCLEATION OF THE PROSTATE?

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP59-12 CAN ANATOMICAL MEASUREMENTS ON PREOPERATIVE PELVIC MAGNETIC RESONANCE IMAGING PREDICT POSTOPERATIVE URINARY INCONTINENCE AFTER HOLMIUM LASER ENUCLEATION OF THE PROSTATE? Amir Khan, Ankur Choksi, Syed Rahman, Benjamin Press, Michael Jalfon, Mursal Gardezi, Tashzna Jones, Christopher Hayden, Eric Ghiraldi, Michael Siev, Gregory Lacy, Preston Sprenkle, and Daniel Kellner Amir KhanAmir Khan More articles by this author , Ankur ChoksiAnkur Choksi More articles by this author , Syed RahmanSyed Rahman More articles by this author , Benjamin PressBenjamin Press More articles by this author , Michael JalfonMichael Jalfon More articles by this author , Mursal GardeziMursal Gardezi More articles by this author , Tashzna JonesTashzna Jones More articles by this author , Christopher HaydenChristopher Hayden More articles by this author , Eric GhiraldiEric Ghiraldi More articles by this author , Michael SievMichael Siev More articles by this author , Gregory LacyGregory Lacy More articles by this author , Preston SprenklePreston Sprenkle More articles by this author , and Daniel KellnerDaniel Kellner More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003312.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Anatomical dimensions of the prostate and membranous urethra have been associated with urinary incontinence after robotic prostatectomy. However, such measures have not been extensively studied with regards to urinary incontinence after holmium laser enucleation of the prostate (HoLEP). Our objective was to assess the impact of preoperative measurements of membranous urethral length (MUL), membranous urethral angle (MUA), levator ani thickness (LAT), and intravesical prostatic protrusion length (IPPL) and whether they can be utilized to predict early postoperative urinary incontinence after HoLEP. METHODS: We retrospectively reviewed our institutional HoLEP database for patients with available preoperative MRI pelvis/prostate from April 2019-June 2022. MRIs were analyzed for MUL (mm), MUA (degrees), LAT (mm), and IPPL (mm). Logistic regression analysis was performed defining urinary continence as <1 pad per day. Analysis was adjusted for age, body mass index, post-void residual, preoperative incontinence, and prostate-specific antigen (PSA). Separate analyses were performed using MUL, MUA, LAT, and IPPL. RESULTS: 128 patients were identified with preoperative MRIs that underwent HoLEP (Table 1). The median age was 69.3 (59.2-77.3) and median preoperative PSA of 5.9 (1.6-33.2). At 1 month, MUL, MUA, LAT, and IPPL were not found to be significantly associated with incontinence (p=0.31, 0.45, 0.27, and 0.86, respectively). Similarly, at 3 months, MUL, MUA, and LAT were not associated with incontinence (p=0.66, 0.42, 0.31, respectively). However, IPPL was found to be associated with urinary incontinence at 3 months (OR=1.09 [1.01-1.29] p=0.049). CONCLUSIONS: Preoperative measurement of IPPL is associated with postoperative urinary incontinence after HoLEP. Further anatomic features such as MUL, MUA, and LAT, which have been associated with incontinence after robotic prostatectomy, do not have an effect on postoperative incontinence after HoLEP in our study, suggesting such anatomical variations may play less of a role in postoperative incontinence. Further studies are needed to assess the impact of anatomical dimensions on surgical outcomes after HoLEP. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e812 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Amir Khan More articles by this author Ankur Choksi More articles by this author Syed Rahman More articles by this author Benjamin Press More articles by this author Michael Jalfon More articles by this author Mursal Gardezi More articles by this author Tashzna Jones More articles by this author Christopher Hayden More articles by this author Eric Ghiraldi More articles by this author Michael Siev More articles by this author Gregory Lacy More articles by this author Preston Sprenkle More articles by this author Daniel Kellner More articles by this author Expand All Advertisement PDF downloadLoading ...