The narrow vesicourethral angle measured on postoperative cystography can predict urinary incontinence after robot-assisted laparoscopic radical prostatectomy

Sugi, Motohiko; Kinoshita, Hidefumi; Yoshida, Takashi; Taniguchi, Hisanori; Mishima, Takao; Yoshida, Kenji; Yanishi, Masaaki; Komai, Yoshihiro; Watanabe, Masahiro; Matsuda, Tadashi

doi:10.1080/21681805.2018.1428683

Cited by 12 publications

(19 citation statements)

References 18 publications

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“…The VBDD was not significantly different between the two groups preoperatively and postoperatively, suggesting that urethral hypermobility during voiding is not involved in PPI. Some studies have advocated that a smaller PUVA after RP contributes to early continence recovery 19,25 . In our study, the PUVA of the continence group was significantly smaller than that of the incontinence group during the resting and voiding phases only after surgery, thus supporting the results of previous studies.…”

Section: Discussionsupporting

confidence: 90%

Cine magnetic resonance imaging provides novel predictors of early continence recovery after radical prostatectomy: Assessment of the dynamics of pelvic floor muscles

Shimura

Kuwahara²,

Aikawa³

et al. 2020

Neurourology and Urodynamics

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Aims: Postprostatectomy incontinence is a major complication of prostatectomy. Although pelvic floor muscle training can successfully treat postprostatectomy incontinence, evidence for how muscle movement affects continence recovery is lacking. We evaluated dynamic factors of prostatectomy patients using cine magnetic resonance imaging to identify risk factors for postprostatectomy incontinence and reveal the contribution of pelvic floor muscles to continence recovery. Methods: A total of 128 prostate cancer patients who underwent robotassisted laparoscopic surgery were enrolled. Cine magnetic resonance imaging was performed preoperatively and 6 months after surgery. Continence was defined as pad-free or use of safety pads. We defined the bladder neck elevation distance during pelvic floor muscle training as the bladder elevation distance. Patients with continence recovery within 1 month comprised the continence group (n = 48); other patients comprised the incontinence group (n = 80). Results: The preoperative bladder elevation distance was significantly longer in the continence group than in the incontinence group (10.4 vs. 8.2 mm; p < .001). The postoperative bladder elevation distance of the continence group tended to be longer (9.9 vs. 8.9 mm; p = .057). Multivariate analysis showed that the preoperative bladder elevation distance significantly contributed to continence recovery (p = .016). Patients with a longer preoperative bladder elevation distance (>8.5 mm) experienced continence recovery significantly faster than patients with a shorter distance (<8.5mm) (p = .038).

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Section: Discussionsupporting

confidence: 90%

Cine magnetic resonance imaging provides novel predictors of early continence recovery after radical prostatectomy: Assessment of the dynamics of pelvic floor muscles

Shimura

Kuwahara²,

Aikawa³

et al. 2020

Neurourology and Urodynamics

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“…Postoperative cystography is a useful tool for predicting post-prostatectomy incontinence. A higher vesico-urethral anastomosis location is associated with a higher rate of early recovery of UC, and a wider bladder neck angle is associated with a high rate of early recovery of UC (12)(13)(14)(15)(16). Our data also demonstrated that early recovery of UC was observed in patients with wider bladder neck angle, however the postoperative location of bladder neck did not show any significant association with early recover of UC after NNS-LRP in multivariate analysis.…”

Section: Discussionsupporting

confidence: 51%

“…Previous studies have reported several factors associated with postoperative UI: i) demographic factors, including age, prostate volume, prostatic apical shape, membranous urethral length and preoperative lower urinary tract symptoms (LUTS) (3)(4)(5)(6)(7)(8), ii) surgical technique-related factors, including posterior and anterior wall reconstruction, nerve sparing procedure, and bladder neck preservation, which are potentially related to the early recovery of postoperative urinary continence (UC) (9)(10)(11). In addition to preoperative and intraoperative factors, postoperative findings, such as cystography suggested to be a reliable tool for predicting postoperative UI (12)(13)(14)(15)(16).…”

mentioning

confidence: 99%

A Combination of Findings Obtained from Pre- and Postoperative Imaging Predict Recovery of Urinary Continence After Non-nerve-sparing Laparoscopic Radical Prostatectomy

et al. 2018

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“…This method was simple, but it did not offer an immediate predictor of continence recovery following catheter removal. Several researches [3][4][5] reported their static cystographic findings after prostatectomy. As they have been reported, many static cystographic findings could estimate the postoperative urinary continence.…”

Section: Discussionmentioning

confidence: 99%

“…These injuries often delay patients' recovery from postoperative incontinence [1]. Therefore, many researchers reported the various static imaging parameters to represent the postoperative status of periurethral muscles [3][4][5]. However, we believed that this status should be evaluated with dynamic diagnostic methods.…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of Cystography-Measured Bladder Neck Elevation at Predicting the Return of Continence After Robot-Assisted Radical Prostatectomy

Huh

Kim

et al. 2019

Int Neurourol J

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To analyze the clinical parameters correlated with early recovery of urinary continence after radical prostatectomy, with a focus on urethral mobility during pelvic contraction at catheter removal. Methods: We prospectively analyzed 67 patients who underwent prostatectomy for prostate cancer at Jeju National University Hospital from January 2015 to June 2018. At the time of catheter removal, a cystography was performed in 67 men (median age, 65 years; range, 55-76 years) who had undergone robot-assisted laparoscopic prostatectomy. The vertical length of bladder neck movement between relaxing and contracting the pelvic muscles was measured. The correlation between the rate of continence recovery and the length of urethral movement was also assessed. All participants were divided into 2 groups according to the length of bladder neck elevation. Group 1 had ≥ 0.6 cm of elevation, while group 2 demonstrated < 0.6 cm of elevation. Results: A reverse correlation existed between the length of urethral movement and the recovery rate of urinary continence (r=-0.488, P < 0.001). The optimal cutoff value for length of urethral movement was found to be 0.6 cm among patients (area under the curve, 0.703). A statistically significant difference was observed between group 1 (length ≥0.6 cm) and group 2 (<0.6 cm) (P < 0.05). Multivariate regression analysis showed that urethral movement predicted the postoperative urinary incontinence. Conclusions: The extent of bladder neck elevation after robot-assisted laparoscopic prostatectomy, which can be easily evaluated using cystography, may be a good predictor of the recovery of urinary continence.

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The narrow vesicourethral angle measured on postoperative cystography can predict urinary incontinence after robot-assisted laparoscopic radical prostatectomy

Abstract: A narrow vesical angle measured on cystography is a useful predictor of postoperative urinary incontinence after RALP.

Cited by 12 publications

References 18 publications

Cine magnetic resonance imaging provides novel predictors of early continence recovery after radical prostatectomy: Assessment of the dynamics of pelvic floor muscles

Cine magnetic resonance imaging provides novel predictors of early continence recovery after radical prostatectomy: Assessment of the dynamics of pelvic floor muscles

A Combination of Findings Obtained from Pre- and Postoperative Imaging Predict Recovery of Urinary Continence After Non-nerve-sparing Laparoscopic Radical Prostatectomy

The Effectiveness of Cystography-Measured Bladder Neck Elevation at Predicting the Return of Continence After Robot-Assisted Radical Prostatectomy

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