Predictors of Early Continence After Single-port Transvesical Robot-assisted Radical Prostatectomy

Abstract

BackgroundSingle-port (SP) transvesical (TV) robot-assisted radical prostatectomy (RARP) is a feasible approach for patients with clinically localized prostate cancer. Our aim is to identify the factors associated with a short time of return to continence. MethodsWe analyzed the first 110 SP TV RARP consecutive cases performed by one surgeon from 2020 to 2022. Continence was defined as zero to one safety pad. Two statistical analyses were done. First, patients were divided: Group A (n=62) included individuals who achieved continence within the initial week post-catheter removal; Group B (n=48) rest of the patients. Descriptive statistics were compared, followed by logistic regression for independent variables. Second, time to continence was analyzed as a continuous variable employing linear regression. The primary outcomes were the independent variables significantly associated with a short time to continence. ResultsAll cases were completed successfully, without additional ports or conversions. Median urinary catheter duration and time to continence were three and 3.5 days, respectively. Patients achieving continence within one week significantly presented with fewer preoperative urinary tract symptoms, lower PSA levels, and had smaller specimen weights postoperatively. Multivariable logistic regression established low specimen weight as the sole significant factor (p=0.04). Furthermore, linear regression demonstrated that alterations in independent variables accounted for 12.7% of the variance in time to continence (p=0.62). ConclusionsThe regionalization of surgery to the bladder employing a retropubic space-sparing extraperitoneal approach during SP TV RARP contributes to a fast return to continence. According to our model, the factors that significantly predict a shorter time to continence include lower preoperative IPSS, PSA, and postoperative specimen weight.