Evaluating Urinary Continence and Preoperative Predictors of Urinary Continence After Robot Assisted Laparoscopic Radical Prostatectomy

Novara, Giacomo; Ficarra, Vincenzo; D’Elia, Carolina; Secco, Silvia; Cioffi, Antonio; Cavalleri, Stefano; Artibani, Walter

doi:10.1016/j.juro.2010.04.069

Cited by 144 publications

(103 citation statements)

References 29 publications

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“…This results is in accordance with other studies evaluating long-term continence outcomes [25,26]. Only Moul et al [27] reported pathological stage as a factor significantly predicting urinary incontinence.…”

Section: Discussionsupporting

confidence: 91%

Age Is Predictive of Immediate Postoperative Urinary Continence after Radical Retropubic Prostatectomy

Campodonico

Manuputty²,

Campora³

et al. 2013

Urol Int

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Introduction: Immediate continence is a goal to take into consideration for better patient satisfaction after radical prostatectomy. Factors predicting urinary continence at catheter removal were investigated. Materials and Methods: We evaluated preoperative, operative, clinical, hormonal and pathological variables in a homogeneous series of radical retropubic prostatectomies (RRPs) following the principles of urinary sphincter restoration technique. Results: The study included 201 patients who underwent RRP. The overall immediate continence rate at catheter removal was 67.7% (136 patients); 28.8% (58 patients) were using one protective pad daily and 3.5% (7 patients) were incontinent. At 6-month follow-up incontinence had reached the lowest level of 2.5% (5 patients) and at 12 months the patients using one pad daily had decreased to 11.9% (24 patients). Multivariate logistic analysis showed that the only two factors independently associated with immediate continence were age <65 years (OR = 2.63, 95% CI 1.13-5.88, p = 0.02) and potency (OR = 3.6, 95% CI 1.2-10.7, p = 0.01) adjusting for D'Amico risk group, surgical margins, extracapsular extension, clinical stage, PSA, testosterone, LH and FSH. No significant association was noted for PSA, hormonal levels, hospital stay, prostate size, clinical stage, risk group, TNM stage, pathological Gleason score or extracapsular extension. Conclusions: In our series age <65 years was associated with immediate continence after RRP. Moreover, patients who were immediately continent had a 3.6-fold probability to be potent within 12 months.

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Section: Discussionsupporting

confidence: 91%

Age Is Predictive of Immediate Postoperative Urinary Continence after Radical Retropubic Prostatectomy

Campodonico

Manuputty²,

Campora³

et al. 2013

Urol Int

View full text Add to dashboard Cite

show abstract

“…[21][22][23][24] In a study assessing time to continence following RARP, Mendiola and colleagues have demonstrated that younger men will likely have an earlier return of continence compared to older men. However, continence outcomes were equal among age groups after 1 year of follow-up.…”

Section: Discussionmentioning

confidence: 99%

Predictors of early continence following robot-assisted radical prostatectomy

Lavigueur-Blouin

Noriega

Valdivieso

et al. 2015

CUAJ

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Introduction: Functional outcomes after robot-assisted radical prostatectomy (RARP) greatly influence patient quality of life. Data regarding predictors of early continence, especially 1 month following RARP, are limited. Previous reports mainly address immediate or 3-month postoperative continence rates. We examine preoperative predictors of pad-free continence recovery at the first follow-up visit 1 month after RARP. Methods: Between January 2007 and January 2013, preoperative and follow-up data were prospectively collected for 327 RARP patients operated on by 2 fellowship-trained surgeons (AEH and KCZ). Patient and operative characteristics included age, body mass index (BMI), staging, preoperative prostate-specific antigen (PSA), prostate weight, International Prostate Symptom Score (IPSS), Sexual Health Inventory for Men (SHIM) score and type of nervesparing performed. Continence was defined by 0-pad usage at 1 month follow-up. Univariate and multivariate logistic regression models were used to assess for predictors of early continence. Results: Overall, 44% of patients were pad-free 1 month post-RARP. In multivariate regression analysis, age (odds ratio [OR] 0.946, confidence interval [CI] 95%: 0.91, 0.98) and IPSS (OR: 0.953, CI 95%: 0.92, 0.99) were independent predictors of urinary continence 1 month following RARP. Other variables (BMI, staging, preoperative PSA, SHIM score, prostate weight and type of nerve-sparing) were not statistically significant predictors of early continence. Limitations of this study include missing data for comorbidities, patient use of pelvic floor exercises and patient maximal activity. Moreover, patient-reported continence using a 0-pad usage definition represents a semiquantitative and subjective measurement. Conclusion: In a broad population of patients who underwent RARP at our institution, 44% of patients were pad-free at 1 month. Age and IPSS were independent predictors of early continence after surgery. Men of advanced age and those with significant lower urinary tract symptoms prior to RARP should be counselled on the increased risk of urinary incontinence in the early stages.

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“…[16] Factors including older age, higher body mass index, increasing comorbidity index, preoperative lower urinary tract symptoms, greater prostate volume, and the postoperative development of an anastomotic stricture have been associated with an increased risk for persistent incontinence. [16][17][18] Rates of erectile dysfunction after RP range from 31 to 86%, [16] depending on the definition of potency, the population studied, and the timeframe evaluated. Factors associated with postoperative erectile function include age, preoperative erectile function, comorbidity status, body mass index, pre-treatment PSA, the extent of nerve-sparing performed at surgery.…”

Section: Radical Therapiesmentioning

confidence: 99%