Duration and Influencing Factors of Postoperative Urinary Incontinence after Robot-Assisted Radical Prostatectomy in a Japanese Community Hospital: A Single-Center Retrospective Cohort Study

Abstract

Objectives: Post-operative urinary incontinence (PUI) after robotic-assisted radical prostatectomy (RARP) is an important complication; PUI occurs immediately after postoperative urethral catheter removal, and, although approximately 90% of patients improve within one year after surgery, it can significantly worsen their quality of life. However, information is lacking on its nature in community hospital settings, particularly in Asian countries. The purposes of this study were to investigate the time required to recover from PUI after RARP and to identify its associated factors in a Japanese community hospital. Methods: Data were extracted from the medical records of 214 men with prostate cancer who underwent RARP from 2019 to 2021. We then calculated the number of days elapsed from the surgery to the initial outpatient visit confirming PUI recovery among the patients. We estimated the PUI recovery rate using the Kaplan–Meier product limit method and evaluated associated factors using the multivariable Cox proportional hazards model. Results: The PUI recovery rates were 5.7%, 23.4%, 64.6%, and 93.3% at 30, 90, 180, and 365 days following RARP, respectively. After an adjustment, those with preoperative urinary incontinence experienced significantly slower PUI recovery than their counterparts, while those with bilateral nerve sparing experienced recovery significantly sooner than those with no nerve sparing. Conclusion: Most PUI improved within one year, but a proportion of those experiencing recovery before 90 days was smaller than previously reported.

Application of anatomic reconstruction technique for periurethral structure in robotic assisted laparoscopic radical prostatectomy

“…However, due to the serious impact of postoperative urinary incontinence on the life quality of patients ( 2 ), how to improve postoperative urinary control has been a research hotspot in urology for a long time. The PUI(Post-operative urinary incontinence) recovery rates were 5.7%, 23.4%, 64.6%, and 93.3% at 30, 90, 180, and 365 days following RARP ( 3 ). At present, numerous researches are devoted to the reconstruction of urine control tissue structure during operation, and have made some achievements, but in fact, these researches often only focus on reconstructing part of the structure of the anterior or posterior wall ( 4 ).…”

The therapeutic effect of pelvic floor muscle training on stress urinary incontinence following prostatectomy: a systematic review and meta-analysis

“…Urinary incontinence is common after RP, occurring in 2% to 87% of patients ( 4 , 5 ). While continence improves in most men over time, this recovery time is variable with some patients requiring up to 12 months ( 6 , 7 ). In addition, a large proportion of men fail to achieve complete continence at any point and suffer from long-term leakage and impact on quality of life.…”