A prognostic model for predicting urinary incontinence after robot‐assisted radical prostatectomy

Honda, Masashi; Kawamoto, Bunya; Morizane, Shuichi; Hikita, Katsuya; Muraoka, Kazuyuki; Sejima, Takehiro; Takenaka, Atsushi

doi:10.1002/rcs.1780

Cited by 20 publications

(27 citation statements)

References 33 publications

(35 reference statements)

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“…CR gradually improves at these times. Our results are in agreement with the recent study by Honda and assists which found that CRs at one, three, and six months were 40.7%, 63.0%, and 73.1%, respectively [15]. The definition of postoperative urinary continence varied among several studies.…”

Section: Discussionsupporting

confidence: 92%

“…Despite technical and methodological improvements in RP, UI does occur and negatively affects quality of life [17]. Assessment of predictors associated with urinary continence has been tried in many studies [7,15,18,19]. This is important for patients and surgeons [18].…”

Section: Discussionmentioning

confidence: 99%

“…For example, Yanagiuchi and co-workers examined and identified outcomes one and three months post RARP, while Olgin and Haga analyzed and evaluated outcomes three and 12 months after surgery [12][13][14]. In addition, Honda and colleagues reported continuous outcomes from one to six months postoperatively [15].…”

mentioning

confidence: 99%

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Urinary continence outcomes of four years of follow-up and predictors of early and late urinary continence in patients undergoing robot-assisted radical prostatectomy

Zhang

Jia

et al. 2019

Preprint

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Background: Although the wide application of robot-assisted radical prostatectomy (RARP) in recent years, studies about long urinary continence were few. In this study, we aimed to examine the outcomes of continence rates (CRs) and determine the risk and protective factors of early and late urinary continence in patients with prostate cancer (PCa) undergoing RARP. Methods: This retrospective study included 650 patients treated with RARP who completed perioperative data and at least one year of follow-up from January 2009 to November 2017. We analyzed the preoperative, intraoperative, and postoperative parameters of the patients. Continence was defined as no pad use.CRs from one to 48 months postoperatively were examined. Logistic regression analysis was performed to evaluate the associations between the predictive factors and urinary continence in the early and late stages. Results: CRs of the patients at one, three, six, 12, 24, 36, and 48 months postoperatively were 40.62%, 60.92%, 71.38%, 78.77%, 79.96%, 79.51%, and 76.50%, respectively.There were no significant differences in CR from 12 to 48 months postoperatively (P=0.766). Logistic regression analysis proved that pelvic lymph node dissection (PLND) was a significant risk factor of urinary continence at one month. Nerve sparing (NS) was a significant protective factor of urinary continence at one, three and six months. Age was an independent risk factor of urinary continence at six, 12 and 24 months. Other variables were not statistically significant predictors. Conclusions: Our results demonstrated that CR gradually improved with time within one year and stabilized one year after the surgery. PLND, NS and age were significant determinants of continence in the early and late stages, respectively. These parameters could be used for preoperatively identifying patients at high risk for urinary incontinence and counselling about postoperative expectations for urinary continence. BackgroundDespite advances in surgical technique and methodology, postprostatectomy urinary incontinence (UI) remains a significant adverse event that leads to decreased quality of life [1,2]. It has been suggested that a number of factors are involved in recovery of urinary continence after radical prostatectomy (RP) [3,4]. Many patients have learned about this disease from the media. Hence, it is necessary to predict recovery of urinary continence early to minimize patients' concerns and

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Urinary continence outcomes of four years of follow-up and predictors of early and late urinary continence in patients undergoing robot-assisted radical prostatectomy

Zhang

Jia

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…Despite technical and methodological improvements in RP, UI does occur and negatively affects quality of life [17]. Assessment of risk factors associated with UI has been tried in many studies [7,14,18,19]. This is important for patients and surgeons [18].…”

Section: Discussionmentioning

confidence: 99%

“…For example, Yanagiuchi and co-workers examined and identified outcomes one and three months post RARP, while Olgin and Haga analyzed and evaluated outcomes three and 12 months after surgery [11][12][13]. In addition, Honda and colleagues reported continuous outcomes from one to six months postoperatively [14].…”

Section: Introductionmentioning

confidence: 99%

Urinary continence outcomes of four years of follow-up and predictors of early and late urinary incontinence in patients undergoing robot-assisted radical prostatectomy

Zhang

Jia

et al. 2019

Preprint

View full text Add to dashboard Cite

Background Although the wide application of robot-assisted radical prostatectomy (RARP) in recent years, studies about long urinary continence were few. In this study, we aimed to examine the outcomes of continence rates (CRs) and determine the predictive factors of early and late urinary incontinence (UI) in patients with prostate cancer (PCa) undergoing RARP.Methods This retrospective study included 650 patients treated with RARP who completed perioperative data and at least one year of follow-up from January 2009 to November 2017. We analyzed the preoperative, intraoperative, and postoperative parameters of the patients. Continence was defined as no pad use. CRs from one to 48 months postoperatively were examined. Logistic regression analysis was performed to evaluate the associations between the risk factors and UI in the early and late stages.Results CRs of the patients at one, three, six, 12, 24, 36, and 48 months postoperatively were 40.62%, 60.92%, 71.38%, 78.77%, 79.96%, 79.51%, and 76.50%, respectively. There were no significant differences in CR from 12 to 48 months postoperatively ( P =0.766). Logistic regression analysis proved that pelvic lymph node dissection (PLND) was a significant predictor of UI at one month, while age was an independent predictor of UI at six and 12 months, respectively. Other variables were not statistically significant predictors.Conclusions Our results demonstrated that CR gradually improved with time within one year and stabilized one year after the surgery. PLND and age were significant determinants of continence in the early and late stages, respectively. These parameters could be used for preoperatively identifying patients at high risk for UI and counselling about postoperative expectations for urinary continence.

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Urodynamic evaluation before and after to RARP to identify pre and intraoperative factors affecting postoperative continence

Majima

Matsukawa

Funahashi

et al. 2021

Neurourology and Urodynamics

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Aims To investigate factors contributing to pre and postoperative urethral function in male patients who underwent robot‐assisted radical prostatectomy (RARP) using the urethral pressure profile (UPP). Methods Study A A total of 313 patients who underwent RARP between April 2013 and March 2015 were prospectively investigated. UPP was performed preoperatively in all patients. Correlation and multiple regression analyses were performed to investigate predictive factors for low preoperative maximum urethral closure pressure (MUCP). Study B To validate the predictive factors for low preoperative MUCP obtained in Study A, 755 patients who underwent RARP between May 2010 and October 2017 were retrospectively examined. Relationships between the time to pad‐free status and the following factors were investigated: number of predictive factors, nerve‐sparing surgery, and vesicourethral anastomosis (VUA) methods (barbed vs. nonbarbed suture). Results Study A A total of 187 patients were enrolled. Multivariate analysis revealed that older age, large prostate volume, low erectile function domain scores in International Index Erectile Function 15, and use of calcium channel blockers were significantly associated with low preoperative MUCP. Study B A total of 515 patients were included. Cox proportional hazard regression showed that the number of predictive factors and VUA method were significantly associated with the time to pad‐free status. Conclusions Our study demonstrated that older age, larger prostate volume, poor erectile function, and calcium channel blocker use could be predictive markers for recovery from postprostatectomy urinary incontinence.

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A prognostic model for predicting urinary incontinence after robot‐assisted radical prostatectomy

Abstract: We developed a novel prognostic model based on preoperative patient data that can be used for patient counselling.

Cited by 20 publications

References 33 publications

Urinary continence outcomes of four years of follow-up and predictors of early and late urinary continence in patients undergoing robot-assisted radical prostatectomy

Urinary continence outcomes of four years of follow-up and predictors of early and late urinary continence in patients undergoing robot-assisted radical prostatectomy

Urinary continence outcomes of four years of follow-up and predictors of early and late urinary incontinence in patients undergoing robot-assisted radical prostatectomy

Urodynamic evaluation before and after to RARP to identify pre and intraoperative factors affecting postoperative continence

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