Preoperative magnetic resonance imaging in predicting early continence recovery after robotic radical prostatectomy

Anatomical predictors of long‐term urinary incontinence after robot‐assisted laparoscopic prostatectomy: A systematic review

“…The study by Sadahira et al 14 indicated that the LAM thickness was significantly associated to UI, with an OR of 0.59 (95% CI: 0.37–0.92); the average LAM thickness was 11.3 mm in continent patients and 9.2 mm in incontinent patients ( p = .001). On the other hand, the risk of UI 1 year after RALP was not found to be linked with the prostate‐seminal angle ( p > .05) in the study by Regis et al 12 Similarly, no significant association was found between the risk of UI and the transverse MUT (HR, 1.057 [95% CI: 0.653–1.483]), the IPL (HR, 1.115 [95% CI: 0.939–1.324]) and the axial Surface area of membranous urethra (HR, 1.008 [95% CI: 0.998–1.013]) in the univariant regression by Kim et al 17 Finally, IPP [OR, 0.99 (95% CI: 0.87–1.14]) and LAM [OR 0.98 [95% CI: 0.87–1.10]) had no effect on the risk of UI 12 months after surgery in the multivariant regression by Hikita et al 10 (Table 2).…”

“…All studies related MUL to UI at 1 year after the surgery in the univariate analysis, except Hikita et al 10 as they focused on the effect of the IPP and only included the MUL in the multivariant study as a confounding factor. All articles except three (Hikita et al, 10 Kitamura et al 11 and Regis et al 12 ) found an association between MUL and UI at 1 year in multivariate analysis (Table 2).…”

“…An analysis of the studies included in this review shows an apparently consistent relation between MUL in preoperative MRI and long‐term UI after RALP, as all but three articles found significant relationship between these two variables in the multivariate analysis. Of these three articles, Regis et al 12 did find an association between MUL and UI at 1 year in univariate analysis, and Kitamura et al 11 did find a relationship between MUL and the speed of recovery from UI up to 1 year after surgery. One aspect that may have influenced these results was that neither of these three articles adjusted incontinence to diabetes, a factor that has been associated with UI; this may have distorted the results.…”

“…One aspect that made it difficult to generalize the results was the heterogeneity of MRI resolution. Regis et al, 12 Schmid et al 15 and Kim et al 17 used 3 T MRI, Kitamura 11 et al used 1.5 T MRI, and Sadahira 14 et al used both 3 T and 1.5 T MRI. Furthermore, in the studies by Kitamura 11 and Sadahira 14 MRI measurements were made by a urologist, and in the article by Regis 12 they were analyzed by a urologist but doubtful cases were consulted with a radiologist.…”

“…Regis et al, 12 Schmid et al 15 and Kim et al 17 used 3 T MRI, Kitamura 11 et al used 1.5 T MRI, and Sadahira 14 et al used both 3 T and 1.5 T MRI. Furthermore, in the studies by Kitamura 11 and Sadahira 14 MRI measurements were made by a urologist, and in the article by Regis 12 they were analyzed by a urologist but doubtful cases were consulted with a radiologist. However in the studies by Schmid et al, 15 Lin et al, 16 and Kim et al 17 MRIs were analyzed by radiologists; interestingly, greater MUL was significantly associated with lower risk of UI in all these multivariate analysis.…”