You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Male Incontinence: Therapy I (MP40)1 Apr 2020MP40-04 ANATOMICAL PROSTATE MPMRI FEATURES AND CONTINENCE RECOVERY AFTER ROBOT ASSISTED RADICAL PROSTATECTOMY: IS THERE SOMETHING BEYOND MEMBRANOUS URETHRAL LENGTH? RESULTS FROM A LARGE, MULTI-INSTITUTIONAL COHORT Manuela Tutolo*, Giorgio Stabile, Giovanni Tasso, Wouter Everaerts, Steven Joniau, Dirk de Ridder, Frank Van der AA, Luk Bruyneel, Ben Van Cleynenbreugel, Francesco De Cobelli, Antonio Esposito, Donato Cannoletta, Vito Cucchiara, Emanuele Zaffuto, Vincenzo Mirone, Matteo Menean, Vincenzo Mirone, Andrea Salonia, Nicola Fossati, Giorgio Gandaglia, Francesco Montorsi, and Alberto Briganti Manuela Tutolo*Manuela Tutolo* More articles by this author , Giorgio StabileGiorgio Stabile More articles by this author , Giovanni TassoGiovanni Tasso More articles by this author , Wouter EveraertsWouter Everaerts More articles by this author , Steven JoniauSteven Joniau More articles by this author , Dirk de RidderDirk de Ridder More articles by this author , Frank Van der AAFrank Van der AA More articles by this author , Luk BruyneelLuk Bruyneel More articles by this author , Ben Van CleynenbreugelBen Van Cleynenbreugel More articles by this author , Francesco De CobelliFrancesco De Cobelli More articles by this author , Antonio EspositoAntonio Esposito More articles by this author , Donato CannolettaDonato Cannoletta More articles by this author , Vito CucchiaraVito Cucchiara More articles by this author , Emanuele ZaffutoEmanuele Zaffuto More articles by this author , Vincenzo MironeVincenzo Mirone More articles by this author , Matteo MeneanMatteo Menean More articles by this author , Vincenzo MironeVincenzo Mirone More articles by this author , Andrea SaloniaAndrea Salonia More articles by this author , Nicola FossatiNicola Fossati More articles by this author , Giorgio GandagliaGiorgio Gandaglia More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Alberto BrigantiAlberto Briganti More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000889.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Membranous urethral length (MUL), measured via MRI, is one of the variables that can contribute to continence recovery (CR). However, to date, there is lack of consensus on the role of other MRI parameters potentially related to CR. Our aim was to assess the association between preoperative clinical characteristics and MRI features and postoperative CR. METHODS: The study included 235 patients treated with robot assisted radical prostatectomy (RALP) at two large academic centres. All patients underwent pre-operative 1.5 or 3-Tesla mp-MRI and had complete MRI, clinical, pathological and post-operative data. MRI measurements were performed by 3 trained urologists. Apex overlapping (AO; namely: anterior, posterior, anterior+posterior and no AO), prostate volume (PV), bladder neck shape (BNS; namely: round vs square), levator ani thickness (LAT) and MUL, were measured and reported. Patients were assessed at 1, 6 and 12-months and yearly thereafter. Continence was defined as no pad use. Univariable (UVA) and multivariable (MVA) Cox regression analyses were used to evaluate the association between MRI variables, BMI, age adjusted CCI and CR. RESULTS: Mean follow-up was 22 months. Overall, the 12 and 24-mo continence rates were 78.3% and 82.0%, respectively. Overall, 169 patients (72.3%) had 2 or less comorbidities. Mean BMI was 26 (median 25.6; IQR 23.5- 27.5). Mean PV was 42 cc (median 35; IQR: 27-51). Mean MUL was 15.4 mm (median 15; IQR 13-18). Mean LAT was 10.7 mm (median 10.5; IQR: 9.5-12). Most patients had anterior AO (n=72, 30.9%) or no overlapping (n= 74, 31.3%). The majority of patient had a squared BNS (n=127, 53.8%). At univariable analyses, MUL (HR: 1.04; 95% C.I. 1.01-1.08) and LAT (HR: 1.08; 95% C.I. 1.02-1.16) emerged as significant predictors of CR: all p=0.04. Conversely, all other MRI features were not significantly associated with UC recovery (all p>=0.6). At MVA only MUL (HR: 1.05; 95% C.I. 1.01-1.1) and an age adjusted CCI (HR vs no comorbidities: 0.26 95% C.I. 0.11-0.54) were significantly associated with CR (p=0.03 and p=0.003, respectively). CONCLUSIONS: According to our knowledge, this is the first study assessing the impact of different anatomical features in predicting CR in a large cohort of patients undergoing MRI before surgery. Our results underline the role of MUL, together with clinical and pathological variables, in models predicting CR. While other MRI parameters may not necessarily be assessed, MUL inclusion is recommended. Source of Funding: none © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e586-e586 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Manuela Tutolo* More articles by this author Giorgio Stabile More articles by this author Giovanni Tasso More articles by this author Wouter Everaerts More articles by this author Steven Joniau More articles by this author Dirk de Ridder More articles by this author Frank Van der AA More articles by this author Luk Bruyneel More articles by this author Ben Van Cleynenbreugel More articles by this author Francesco De Cobelli More articles by this author Antonio Esposito More articles by this author Donato Cannoletta More articles by this author Vito Cucchiara More articles by this author Emanuele Zaffuto More articles by this author Vincenzo Mirone More articles by this author Matteo Menean More articles by this author Vincenzo Mirone More articles by this author Andrea Salonia More articles by this author Nicola Fossati More articles by this author Giorgio Gandaglia More articles by this author Francesco Montorsi More articles by this author Alberto Briganti More articles by this author Expand All Advertisement PDF downloadLoading ...