Factors Predicting Early Return of Continence After Radical Prostatectomy

Sandhu, Jaspreet S.; Eastham, James A.

doi:10.1007/s11934-010-0108-6

Cited by 59 publications

(36 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Patient age is the one demographic factor most commonly linked to continence and time to continence; however, the predictive strength of age and all other baseline factors, such as body mass index, prostate weight, AUA symptom score, is weak at best. [12][13][14] Our study confirms these previous findings as presented in Table 1. In addition, we found preoperative uroflowmetry (VV, PVR, PFR) had no predictive findings.…”

Section: Discussionsupporting

confidence: 92%

Simple Method to Predict Return of Continence After Robot-Assisted Radical Prostatectomy

Skarecky

Morales

Chang

et al. 2011

Journal of Endourology

View full text Add to dashboard Cite

Background and Purpose: After removal of the Foley catheter after robot-assisted radical prostatectomy (RARP), recovery of continence can take days to months. We sought to identify a simple means to predict time to recovery of postoperative continence. Patients and Methods: Preoperative characteristics on 172 men who were undergoing RARP were entered into an electronic database. All men were queried via telephone and/or returned a 7-day log of pad use. Men without need for pads were excluded (n = 41). At 4 to 7 days, responses were grouped as: one pad (n = 55), two pads (n = 35), or three or more pads (n = 41). Patients returned self-addressed postcards noting the date of 0-pad urinary status. Univariate and multivariate analysis of variables were assessed for ability to predict time to continence. Results: No preoperative factors, such as age, International Index of Erectile Function-5, prostate-specific antigen level, American Urological Association symptom score, body mass index, uroflowmetry, nervesparing status, estimated blood loss, or prostate weight, were found to predict time to continence. Pad use at 4 to 7 days, however, was highly correlated with median time to continence. The median time to continence for men using one pad was 35 days, two pads was 42 days, and for three or more pads was 73 days (P = 0.0001). Conclusions: As has been previously reported, we found no reliable baseline factors that predicted postoperative time to 0-pad continence. We did find that determining pad usage at 4 to 7 days after catheter removal strongly predicted time to pad-free continence. This method is simpler then pad weights, predicts high-and low-risk men for delayed continence, and can be used for counseling/intervention.

show abstract

Section: Discussionsupporting

confidence: 92%

Simple Method to Predict Return of Continence After Robot-Assisted Radical Prostatectomy

Skarecky

Morales

Chang

et al. 2011

Journal of Endourology

View full text Add to dashboard Cite

show abstract

“…There is no doubt that the surgeon and the surgical technique have an important role in the functional outcomes after RARP [12,21]; we found a difference in incontinence rate between the three surgeons, but not statistically important.…”

Section: Discussionmentioning

confidence: 64%

“…Prostate-specific antigen, grade and stage are not considered RFs for UI [21], an observation founded in our study. Only 1 out of 6 patients with T2c and T3a who underwent extrafascial bilateral procedure had UI at 1 year.…”

Section: Discussionmentioning

confidence: 83%

Comprehensive Prediction Model of Urinary Incontinence One Year following Robot-Assisted Radical Prostatectomy

Barnoiu¹,

Lopez²,

Galisteo³

et al. 2012

Urol Int

View full text Add to dashboard Cite

Objectives: Urinary incontinence (UI) still remains one of the major functional complications after robot-assisted radical prostatectomy (RARP). As the cause for UI is multifactorial, it is quite difficult to make a prediction preoperatively. Considering intraoperative and postoperative risk factors, besides the preoperative ones, we designed an incontinence prediction model, administered 1 month after the surgery, in order to identify incontinent patients at 1 year. Patients and Methods: We retrospectively reviewed 244 patients who underwent RARP at our institution. Only 209 patients had sufficient data, a 1-year follow-up and were continent preoperatively. The association of UI with the risk factors was assessed by univariable and multivariable regression models. Results: There was a 17.2% global UI rate at 1 year after RARP. Only age-adjusted Charlson comorbidity index, erectile function assessed by International Index of Erectile Function-5, prostate volume, nerve-sparing status and 24-hour urine loss at 1 month correlated with UI (p = 0.032, 0.009, 0.031, 0.018 and <0.001, respectively). The accuracy of the prediction model of UI was 92.8% (c-index), with an area under the curve of 91.9%. Conclusion: Age-adjusted Charlson comorbidity index, International Index of Erectile Function-5, prostate volume, nerve-sparing status and 24-hour urine loss at 1 month after RARP can predict an individual’s risk of UI at 1 year after RARP with good accuracy. Further external validation is required in order to generalize the use of this model.

show abstract

“…Büyük serilerin çoğunda, hastalığın evresi ile inkontinans oranları arasında ilişki bulunmamıştır (9,19). Fakat bazı durumlarda hastalığın evresi cerrahi tekniği (örneğin sinir koruyucu) etkileyebilir ve inkontinans oranları yüksek çıkabilir, bu yüksek oran hastalığın evresinin değil cerrahi tekniğin sonucu olarak görünmektedir (8,(19)(20)(21) (24) yapmış olduğu çalışmada sinir koruyucu tekniğin geç kontinansa etkili olduğunu saptamışlardır (24).…”

Section: Yöntemlerunclassified

Retrospective Analysis of Factors Affecting Continence after Robotic Radical Prostatectomy

Törer¹,

Ekşi²,

Kargı³

et al. 2017

JAREM

View full text Add to dashboard Cite

ÖZAmaç: Bu çalışma ile prostat kanseri nedeniyle robot yardımlı radikal prostatektomi yapılan hastalarda kontinansı etkileyen faktörleri değer-lendirmeyi amaçladık. Yöntemler: Ağustos 2009 -Ocak 2014 tarihleri arasında Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi Üroloji Kliniğinde prostat kanseri nedeniyle Robot yardımlı laparaskopik radikal prostatektomi uygulanan 385 hastanın verileri retrospektif olarak incelendi. Bulgular: Preop Uluslararası Erektil İşlev İndexi (IIEF) skoru ≥22 olanlar ile D'Amico sınıflamasına göre düşük riskli hastalarda 12.aydaki kontinans oranı istatistiksel olarak anlamlı yüksek saptandı (p<0,05). Üçüncü aydaki değerlendirmede klasik interfasyal teknik, klasik intrafasyal teknik ve fasya koruyucu intrafasyal teknik uygulanan hastaların klasik ekstrafasyal teknik uygulanan hastalara göre kontinans oranı istatistiksel olarak anlamlı yüksek saptandı (p<0,05). Sinir koruyucu cerrahi yapılan hastalar ile sinir koruyucu cerrahi yapılmayan hastalar karşılaştırıldığında sinir koruyucu cerrahi yapılan hastalarda kontinans oranı istatistiksel olarak anlamlı yüksek saptandı (p<0,05). Sonuç: Biz erken ve geç kontinansın geri kazanılmasında klasik intrafasyal ve fasya koruyucu intrafasyal tekniğin önemli olduğunu saptadık. Bununla birlikte geç kontinansın geri kazanılmasında, hastaların preop IIEF skorunun yüksek olmasının ve D'Amico sınıflamasına göre düşük risk grubunda olmasının önemli olduğunu saptadık. Anahtar kelimeler: Radikal prostatektomi, kontinans, prostat kanseri, robotyardımlıcerrahi ABSTRACT Objective: Objective: In this study, we aimed to evaluate the factors affecting continence in patients who underwent robot-assisted radical prostatectomy for prostate cancer. Methods: Between August 2009 and January 2014, data of 385 patients, who were treated with robot-assisted laparoscopic prostatectomy for prostate cancer at our clinic, was retrospectively analyzed. Results: The continence rate was significantly higher at the 12-month evaluation in patients who preoperatively had an International Index of Erectile Function (IIEF) score of >22 and who were at a low risk according to the D'Amico classification (p<0.05). The continence rate was significantly higher at the 3-month evaluation in patients who underwent interfascial, classical intrafascial, and fascia-sparing intrafascial techniques compared with those who underwent the classical extrafascial technique. The continence rate was significantly higher in patients who underwent a nerve-sparing surgery. Conclusion: We found that for the recovery of early and late continences, the use of classical intrafascial and fascia-sparing intrafascial techniques is important. However, we have determined that being at a low risk according to the D'Amico classification and having a high IIEF score are important for the recovery of late continence.

show abstract

Factors Predicting Early Return of Continence After Radical Prostatectomy

Cited by 59 publications

References 55 publications

Simple Method to Predict Return of Continence After Robot-Assisted Radical Prostatectomy

Simple Method to Predict Return of Continence After Robot-Assisted Radical Prostatectomy

Comprehensive Prediction Model of Urinary Incontinence One Year following Robot-Assisted Radical Prostatectomy

Retrospective Analysis of Factors Affecting Continence after Robotic Radical Prostatectomy

Contact Info

Product

Resources

About