Daily urine loss immediately after urethral catheter removal may be an effective predictor of long‐term urinary incontinence following robot‐assisted laparoscopic radical prostatectomy

Abstract

Purpose Some patients who undergo robot‐assisted laparoscopic radical prostatectomy (RARP) continue to experience long‐term urinary incontinence (UI). This study aimed to evaluate easily obtainable factors that can predict long‐term UI following RARP. Materials and Methods A total of 315 patients who underwent RARP for localised prostatic cancer were analysed. We separated the patients into two groups, namely, the Continence group and the Incontinence group, according to the presence or absence of UI at 12 months after surgery, and we compared the patients’ characteristics and operative data to identify clinical signs associated with long‐term UI. Additionally, correlations between these factors and postoperative urethral function were evaluated. Urinary continence was defined as both the use of 0 pads/per day and <2 g of urine lost using the 24‐hours pad weight test. Results Of 315 patients, 250 (79.4%) achieved urinary continence and 65 (20.6%) had long‐term UI. Age, storage‐related lower urinary tract symptoms before surgery, nerve‐sparing surgery and the 24‐hours urine loss immediately after urethral catheter removal significantly affected long‐term UI after RARP. Multivariate logistic regression analyses revealed that the 24‐hours urine loss after catheter removal was a significant predictor of long‐term UI. Receiver operating characteristic curve analysis identified a urine loss of 330 g/d as the optimal cut‐off value, which yielded 92% sensitivity and 84% specificity, and it showed significant correlations with postoperative urethral function and the time to recover urinary continence. Conclusion The 24‐hours urine loss immediately after urethral catheter removal may be the most reliable and useful predictor of long‐term UI following RARP.

De Novo Detrusor Underactivity and Other Urodynamic Findings after Radical Prostatectomy: A Systematic Review

“…Although less frequently studied, other LUTS are not uncommon after RP [ 5 ]. Unfortunately, the high preoperative incidence of LUTS further complicates research on the impact of surgery on lower urinary tract (LUT) function afterwards [ 6 , 7 , 8 , 9 ].…”

Predictors for lower urinary tract symptoms in patients underwent radical prostatectomy: implications for postoperative nursing care

“…Numerous researches have put effort into identifying factors affecting post‐operative LUTS in patients with PC, which generally include radiation therapy, body mass index (BMI), age, prostate‐specific antigen (PSA) level and post‐operative physical therapy (Khoder et al, 2013 ; Matsukawa et al, 2020 ; Soto González et al, 2020 ). However, few have looked into the effect of nursing intervention, which in fact carries substantial weight for patient quality of life.…”