Significance of urethral fibrosis evaluated by preoperative magnetic resonance imaging as a predictor of continence status after robot-assisted radical prostatectomy.

Abstract

The objective of this study was to assess the impact of urethral fibrosis on the continence status following robot-assisted radical prostatectomy (RARP). The findings of fibrosis of the urethral wall and periurethral tissue in 185 patients undergoing RARP were each divided into grade 0 to 3 based on preoperative T2-weighted magnetic resonance imaging. Urethral fibrosis was defined as the sum of both grades, and scores ≤ 2 and ≥ 3 were considered as 'no/mild' and 'severe' fibrosis, respectively. The incidences of continence in patients with no/mild fibrosis were significantly higher at 3, 6, and 12 months after RARP than those with severe fibrosis. Furthermore, urethral fibrosis was identified as an independent predictor of the postoperative continence status at 3, 6, and 12 months after RARP. Assessment of urethral fibrosis could be a significant predictor of recovery of the urinary continence status after RARP. Copyright © 2015 John Wiley & Sons, Ltd.