MP80-13 ROLE OF PREOPERATIVE MAGNETIC RESONANCE IMAGING IN PREDICTING THE EARLY RECOVERY OF URINARY CONTINENCE AFTER RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy VII1 Apr 2016MP80-13 ROLE OF PREOPERATIVE MAGNETIC RESONANCE IMAGING IN PREDICTING THE EARLY RECOVERY OF URINARY CONTINENCE AFTER RADICAL PROSTATECTOMY Myungchan Park, Seung-Kwon Choi, Myong Kim, Won Hee Park, Jongwon Kim, Cheryn Song, Tai young Ahn, and Hanjong Ahn Myungchan ParkMyungchan Park More articles by this author , Seung-Kwon ChoiSeung-Kwon Choi More articles by this author , Myong KimMyong Kim More articles by this author , Won Hee ParkWon Hee Park More articles by this author , Jongwon KimJongwon Kim More articles by this author , Cheryn SongCheryn Song More articles by this author , Tai young AhnTai young Ahn More articles by this author , and Hanjong AhnHanjong Ahn More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2045AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The predictive value of membranous urethral length (MUL) and shape of the prostatic apex (PA) for early recovery of urinary continence after radical prostatectomy (RP) were evaluated by preoperative magnetic resonance imaging (MRI). METHODS Three-hundred three patients who underwent RP at our institute were prospectively analyzed. The MUL and shape of PA were measured by preoperative MRI. The urethral pressure profiles (UPP) were assessed preoperatively in all patients. The pre- and postoperative UPP were measured in a subgroup of 100 patients to assess the effect of change in UPP on early recovery of continence. Continence, defined pad-free state with no leakage of urine, was assessed at 3 months and 1 year after surgery. RESULTS Of 303 patients, 213 patients (70.3%) initially achieved urinary continence 3moths after surgery, and a total of 251 (82.8%) patients achieved urinary continence 1 year after surgery. The MUL was longer in the continent group than in the incontinent group (11.2 mm vs. 12.4 mm, p=0.001). Patients with the PA covering the membranous urethra on the anterior side (type 1 PA) showed worse urinary continence rates than those without (type 2 PA) (57.9% vs. 89.2%, p<0.001). The subgroup analysis showed that the postoperative percent change in MUCP was higher in patients with type 1 PA (24.4% vs. 14.2%, p = 0.042). Patients with a MUL >12 mm and type 2 PA, showed a markedly increased probability of continence recovery compared to patients with a MUL =12 mm and type 1 PA (odds ratio 27.430, p<0.001). In all patients, the MUL (odds ratio 1.135, p=0.016) and shape of the PA (odds ratio 5.621, p<0.001) were independent preoperative predictors of early continence recovery after RP. The inclusion of MUL and prostatic apical shape on MRI increased the predictive accuracy of the base model from 0.621 to 0.770 (p=0.012). CONCLUSIONS The MUL and shape of the PA on preoperative MRI significantly enhance the prediction of early continence recovery after RP. Maximal preservation of MUL is important during RP, especially for patients with a short MUL or a PA covering the membranous urethra on the anterior side. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1048 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Myungchan Park More articles by this author Seung-Kwon Choi More articles by this author Myong Kim More articles by this author Won Hee Park More articles by this author Jongwon Kim More articles by this author Cheryn Song More articles by this author Tai young Ahn More articles by this author Hanjong Ahn More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...