MP64-20 PREOPERATIVE MEMBRANOUS URETHRAL LENGTH IS ASSOCIATED WITH POST-PROSTATECTOMY URINARY FUNCTION IN ASIAN MEN

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy VI (MP64)1 Sep 2021MP64-20 PREOPERATIVE MEMBRANOUS URETHRAL LENGTH IS ASSOCIATED WITH POST-PROSTATECTOMY URINARY FUNCTION IN ASIAN MEN Spyridon Basourakos, Ashwin Ramaswamy, Miko Yu, Daniel Margolis, and Jim Hu Spyridon BasourakosSpyridon Basourakos More articles by this author , Ashwin RamaswamyAshwin Ramaswamy More articles by this author , Miko YuMiko Yu More articles by this author , Daniel MargolisDaniel Margolis More articles by this author , and Jim HuJim Hu More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002104.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Studies demonstrate that Asian and African-American race (vs. white) and preoperative membranous urethral length (MUL) measured on MRI have been associated with post-radical prostatectomy (RP) urinary incontinence. However, the relationship of race and MUL has not been studied: this is noteworthy given improved patient selection as an approach to minimize the risk of post-RP incontinence. METHODS: We retrospectively identified men who self-identified as “Asian” and underwent robot-assisted RP for localized prostate cancer between 2015 and 2020. After appropriate training of two readers by an expert genitourinary radiologist, MULs were blindly measured by the two readers independently. Urinary function was assessed using the Expanded Prostate Cancer Index for Clinical Practice (EPIC-CP). Baseline clinicopathologic characteristic and imaging measurements were compared with Wilcoxon-Mann-Whitney and χ2 test. We used a generalized estimating equation (GEE) model to evaluate if Asian race is associated with urinary function recovery. RESULTS: There were no racial differences by age (66.8 95%CI 64.7-69.0 vs. 65.6, 95%CI 62.6-68.6; p=0.6), BMI (25.9, 95%CI 24.7-27.2 vs. 26.7, 95%CI 25.7-27.8; p=0.3), PSA (10.3, 95%CI 7.6-12.9 vs. 8.6, 95%CI 6.3-11.0; p=0.4), prostate volume (50.4, 95%CI 37.8-63.0 vs. 41.5, 95%CI 25.9-46.7; p=0.2) or complete nerve sparing status (86% vs. 86%; p=1.0). Asian men had shorter MUL (7.9mm, 95%CI 7.5–8.3 vs. 10.9mm, 95%CI 10.2–11.7; p<0.01) and worse EPIC-CP urinary function scores (3.82; 95%CI 2.47-5.17 vs. 1.95; 95%CI 1.11–2.79; p=0.022) at 12 months post-RP compared to non-Asians. Our GEE model demonstrated that Asian race is associated of a higher (worse) EPIC-CP urinary score when compared to non-Asians (parameter estimate 0.56; 95%CI 0.04-1.08; p=0.034). Furthermore, we found that lower MUL (p=0.03) and Asian race (p=0.036) were associated with increased 12-month EPIC-CP urinary function scores in a multivariate logistic model that included age and BMI. CONCLUSIONS: Asian race was associated with shorter MUL, and both Asian race and shorter MUL are independently associated with worse urinary function. Further confirmatory studies and comparative racial studies of MUL are necessary to better characterize disparities in outcomes. Source of Funding: Jim C. Hu receives research support from the Frederick J. and Theresa Dow Wallace Fund of the New York Community Trust. Jim C. Hu also receives salary support from NIH R01 CA241758 and PCORI CER-2019C1-15682. The remaining authors report no further disclosures related to this work © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1118-e1118 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Spyridon Basourakos More articles by this author Ashwin Ramaswamy More articles by this author Miko Yu More articles by this author Daniel Margolis More articles by this author Jim Hu More articles by this author Expand All Advertisement Loading ...