Relative position of bladder neck to pubic symphysis on cystogram is a strong and reproducible predictor of early urinary continence recovery following radical prostatectomy

Rossanese, Marta; Caloggero, Simona; Alario, Giuseppe; Mucciardi, Giuseppe; Novara, Giacomo; Giannarini, Gianluca; Ficarra, Vincenzo

doi:10.1177/0391560320974891

Cited by 1 publication

(2 citation statements)

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“…Following our pilot study, other studies have confirmed the predictive value of the three specific cystography features for PPI mentioned in our study: more of a downward bladder neck level [ 16 , 19 , 20 , 22 , 24 ], a sharp bladder neck angle [ 18 ], and anastomosis leakage [ 21 ] are associated with a delayed and lower probability of recovery from PPI.…”

Section: Discussionsupporting

confidence: 83%

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Recognition of Postoperative Cystography Features by Artificial Intelligence to Predict Recovery from Postprostatectomy Urinary Incontinence: A Rapid and Easy Way to Predict Functional Outcome

Shao

Kan

Chen

et al. 2023

JPM

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Purpose: Post-operative cystography has been used to predict the recovery of postprostatectomy urinary incontinence (PPI) in patients with localized prostate cancer. This study aimed to validate the predictive value of cystography for PPI and utilize a deep learning model to identify favorable and unfavorable features. Methods: Medical records and cystography images of patients who underwent robotic-assisted radical prostatectomy for localized prostate cancer were retrospectively reviewed. Specific cystography features, including anastomosis leakage, a downward bladder neck (BN), and the bladder neck angle, were analyzed for the prediction of PPI recovery. Favorable and unfavorable patterns were categorized based on the three cystography features. The deep learning model used for transfer learning was ResNet 50 and weights were trained on ImageNet. We used 5-fold cross-validation to reduce bias. After each fold, we used a test set to confirm the model’s performance. Result: A total of 170 consecutive patients were included; 31.2% experienced immediate urinary continence after surgery, while 93.5% achieved a pad-free status and 6.5% were still incontinent in the 24 weeks after surgery. We divided patients into a fast recovery group (≤4 weeks) and a slow recovery group (>4 weeks). Compared with the slow recovery group, the fast recovery group had a significantly lower anastomosis leakage rate, less of a downward bladder neck, and a larger bladder neck angle. Test data used to evaluate the model’s performance demonstrated an average 5-fold accuracy, sensitivity, and specificity of 93.75%, 87.5%, and 100%, respectively. Conclusions: Postoperative cystography features can predict PPI recovery in patients with localized prostate cancer. A deep-learning model can facilitate the identification process. Further validation and exploration are required for the future development of artificial intelligence (AI) in this field.

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Section: Discussionsupporting

confidence: 83%

“…Specific features included a downward bladder neck, the bladder neck angle, and anastomosis leakage [ 15 ]. The predictive value of these specific features in cystography for PPI is now well established [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%