Predictors of urinary function recovery after radical prostatectomy

Abstract

Purpose: Even in the era of laparoscopic radical prostatectomy (LRP) and robot-assisted laparoscopic radical prostatectomy (RALP), we sometimes experience patients with severe urinary incontinence after surgery. The aim of this study was to identify the predictors of urinary continence recovery among patients with urinary incontinence immediately after surgery (UIIAS).Methods: We identified 274 patients with clinically localized prostate cancer who underwent LRP and RALP between 2011 and 2018. UIIAS was defined as a urine loss ratio > 0.15 on the first day of urethral catheter removal. Urinary continence recovery was defined as using ≤ 1 pad/day one year after surgery. In the present study, we evaluated the factors affecting urinary function recovery one year after surgery among patients with urinary incontinence immediately after LRP and RALP.Results: UIIAS was observed in 191 of 274 patients (69.7%). A multivariate analysis identified age (< 65 years, p = 0.015) as an independent predictor affecting immediate urinary continence. Among the 191 incontinent patients, 153 patients (80.1%) showed improved urinary continence one year after surgery. A multivariate analysis identified age (< 65 years, p = 0.003) and estimated blood loss (≥ 100 ml, p = 0.044) as independent predictors affecting urinary continence recovery one year after surgery. Conclusions: The present results suggest that younger patients and patients with higher intraoperative blood loss might recover urinary continence one year after surgery even if they are incontinent immediately after surgery.

Urethroplasty is highlighted in the first number of 2023 in International Brazilian Journal of Urology

“…Dr. Hakozaki and collegues from Japan performed in page 50 ( 4 ) a nice study about the predictors of urinary function recovery after laparoscopic and robotic-assisted radical prostatectomy and concluded that younger patients and patients with higher intraoperative blood loss recover urinary continence one year after surgery even if they are incontinent immediately after surgery.…”