MP74-10 INTRAOPERATIVE MEASUREMENTS OF URETHRAL LENGTH AND BLADDER NECK DIAMETER AS PREDICTORS OF URINARY CONTINENCE AFTER ROBOT-ASSISTED RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy IV (MP74)1 Apr 2020MP74-10 INTRAOPERATIVE MEASUREMENTS OF URETHRAL LENGTH AND BLADDER NECK DIAMETER AS PREDICTORS OF URINARY CONTINENCE AFTER ROBOT-ASSISTED RADICAL PROSTATECTOMY Yasuo Kohjimoto*, Masatoshi Higuchi, Yuko Ueda, Takashi Iguchi, Hiroyuki Koike, Takahito Wakamiya, Shimpei Yamashita, Kazuro Kikkawa, and Isao Hara Yasuo Kohjimoto*Yasuo Kohjimoto* More articles by this author , Masatoshi HiguchiMasatoshi Higuchi More articles by this author , Yuko UedaYuko Ueda More articles by this author , Takashi IguchiTakashi Iguchi More articles by this author , Hiroyuki KoikeHiroyuki Koike More articles by this author , Takahito WakamiyaTakahito Wakamiya More articles by this author , Shimpei YamashitaShimpei Yamashita More articles by this author , Kazuro KikkawaKazuro Kikkawa More articles by this author , and Isao HaraIsao Hara More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000960.010AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To determine whether intraoperative measurements of urethral length (UL) and bladder neck diameter (BND) can predict patient-reported urinary continence status after robot-assisted radical prostatectomy (RARP). METHODS: Consecutive eligible patients undergoing RARP between June 2015 and March 2019 were enrolled into a prospective, longitudinal, observational cohort study. The primary outcomes were changes in urinary incontinence subscale of the Expanded Prostate Cancer Index Composite (EPIC) from baseline at 3, 6 and 12 months postoperatively. The primary exposures were UL and BND measured intraoperatively with a ruler. Other covariates included age, body mass index, NCCN risk category, nerve-sparing and weight of resected specimen. The relationship between EPIC score for urinary incontinence and intraoperative measurements (UL and BND) was evaluated using Wilcoxon-Mann-Whitney test and multivariate logistic regression analysis. RESULTS: A total of 365 patients were enrolled. The median change in EPIC score for urinary incontinence were -41.5, -21.8 and -12.5 at 3, 6, 12 months, respectively. The median UL and BND were 15mm and 17mm, respectively. Decrease in EPIC score for urinary incontinence at 12 months was smaller in patients with UL >15mm than those with UL ≤15mm (-6.3 vs -14.5, p=0.08), and so in patients with BND ≤17mm than those with BND >17mm (-6.3 vs -20.8, p=0.04). However, there were no differences between these groups at 3 and 6 months. Multivariate analyses revealed that patients with UL >15mm (OR 2.53, 95%CI 1.37-4.66, p<0.01) and those with BND ≤17mm (OR 2.70, 95%CI 1.45-5.03, p<0.01) had significantly higher odds of small decrease in EPIC score for urinary incontinence at 12 months (Table). CONCLUSIONS: The results demonstrated that longer UL and smaller BND were associated with significantly small decrease in EPIC score for urinary continence at 12 postoperatively, supporting the idea that preservation of membranous urethra and bladder neck during RARP improves continence recovery. Source of Funding: none © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1135-e1135 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yasuo Kohjimoto* More articles by this author Masatoshi Higuchi More articles by this author Yuko Ueda More articles by this author Takashi Iguchi More articles by this author Hiroyuki Koike More articles by this author Takahito Wakamiya More articles by this author Shimpei Yamashita More articles by this author Kazuro Kikkawa More articles by this author Isao Hara More articles by this author Expand All Advertisement PDF downloadLoading ...