MP67-10 CLINICAL FACTORS ASSOCIATED WITH EARLY RETURN OF URINARY CONTROL FOLLOWING RETZIUS-SPARING ROBOTIC-ASSISTED RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP67-10 CLINICAL FACTORS ASSOCIATED WITH EARLY RETURN OF URINARY CONTROL FOLLOWING RETZIUS-SPARING ROBOTIC-ASSISTED RADICAL PROSTATECTOMY Ruben Blachman-Braun, Dinno F Mendiola, Carole Lahana, Chad R. Ritch, Sanoj Punnen, Bruno Nahar, Dipen J Parekh, and Mark L Gonzalgo Ruben Blachman-BraunRuben Blachman-Braun More articles by this author , Dinno F MendiolaDinno F Mendiola More articles by this author , Carole LahanaCarole Lahana More articles by this author , Chad R. RitchChad R. Ritch More articles by this author , Sanoj PunnenSanoj Punnen More articles by this author , Bruno NaharBruno Nahar More articles by this author , Dipen J ParekhDipen J Parekh More articles by this author , and Mark L GonzalgoMark L Gonzalgo More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003330.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: A potential side effect following radical prostatectomy is urinary incontinence. Retzius-sparing robotic-assisted radical prostatectomy (RS-RARP) has been associated with improved urinary control outcomes. We investigated the impact of clinical variables and intraoperative surgical findings on recovery of urinary control following RS-RARP. METHODS: Data was collected from a single-surgeon, single-institution prospective database of patients who underwent RS-RARP from May 2020 to July 2022 with≥3 months of follow up. Those without EPIC-CP (Expanded Prostate Cancer Index Composite for Clinical Practice) or unknown prostate size at baseline were excluded. Daily pad use and EPIC-CP urinary incontinence symptom score domain (EPIC-CP UISS) were used to assess continence status. Multivariable-adjusted logistic regression was performed to assess clinical variables associated with 3-month continence (EPIC-CP UISS≤3) following surgery. RESULTS: A total of 295 men were analyzed, 49 (16.6%) had a median lobe (ML) confirmed intraoperatively, 27 (9.2%) required bladder neck reconstruction (BNR) using a tennis-racket suturing technique, and 139 (47.1%) had bilateral nerve-sparing (BNS). A total of 145 (49.2%) and 224 (76.6%) men reported using 0 or 0-1 pad per day ≤1 week following catheter removal, respectively. At 3-month follow up, 65.4% and 86.1% of men reported using 0 or 0-1 pad per day, respectively; 81.7% of men had EPIC-CP UISS ≤3. Approximately 90% and 97% of men reported using 0 or 0-1 pad per day 12 months following surgery, respectively. Diabetes mellitus (DM) was associated with worse continence (OR=0.403, p=0.027), and BNS was associated with better continence (OR=3.595, p=0.003) at 3 months. Prostate size, presence of a ML, and BNR were not associated with worse urinary control at 3 months (Table 1). CONCLUSIONS: Early continence rates after RS-RARP are encouraging with the majority of men being completely dry or using 0-1 pad per day within 1 week of catheter removal and by 3 months following surgery. DM has a negative impact and BNS has a positive impact on return of early continence. Age, prostate size, presence of ML, and BNR did not have a significant impact on early recovery of urinary control after RS-RARP. Source of Funding: No © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e946 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ruben Blachman-Braun More articles by this author Dinno F Mendiola More articles by this author Carole Lahana More articles by this author Chad R. Ritch More articles by this author Sanoj Punnen More articles by this author Bruno Nahar More articles by this author Dipen J Parekh More articles by this author Mark L Gonzalgo More articles by this author Expand All Advertisement PDF downloadLoading ...