Urethral mobility at catheter removal predicts early recovery of urinary continence after radical prostatectomy

Abstract

Objectives: To analyze the clinical parameters correlated with early recovery of urinary continence after radical prostatectomy, focusing especially on urethral mobility during voiding at catheter removal. Methods: At the time of catheter removal, a voiding cystourethrography was performed in 58 men (median age 69 years, range 55-76) who had undergone radical prostatectomy. The vertical length of urethral movement between voiding and standstill was measured.The correlation between continence status and various clinical parameters, including age, prostate volume, International Prostate Symptom Score, quality of life score and the length of urethral movement was analyzed. Results: An inverse correlation was observed between length of urethral movement and urinary incontinence volume rate (defined as [leakage volume/daily total urine volume] ¥ 100%) on day 7 after catheter removal (r = -0.388, P < 0.05). Classifying patients into two groups according to the length of urethral movement of 2 mm gave the best accuracy for the prediction of postoperative recovery of urinary incontinence with receiver operating characteristic analysis. A statistically significant difference was observed between group 1 (length Ն 2 mm) and group 2 (<2 mm) for the leakage rate until day 7 after the catheter was removed (P < 0.01). Urethral movement at the time of catheter removal was significantly correlated with early recovery of continence in the two groups (P < 0.05). Conclusions: Urethral mobility after radical prostatectomy, which can be easily evaluated using voiding cystourethrography, may be a good predictor of early recovery of urinary continence.

Factors Contributing to Early Recovery of Urinary Continence Analyzed by Pre- and Postoperative Pelvic Anatomical Features at Robot-Assisted Laparoscopic Radical Prostatectomy

“…5,36 The present study demonstrated that postoperative MUL >17 mm was significantly associated with early acquisition of urinary continence.…”

“…Although a small number of studies have specifically addressed relationships between morphology of the lower urinary tract after radical prostatectomy and urinary incontinence, [4][5][6] no studies specific to RARP have been described, especially for the early postoperative period. 6 6 radical prostatectomy is to maintain normal anatomical and functional structures in the pelvis as much as possible.…”

“…To date, a small number of reports have demonstrated associations between imaging assessment of urethral and vesical anatomical features and urinary incontinence after radical prostatectomy [4][5][6]. However, studies specific to RARP in the early postoperative period have not been reported.…”

“…However, studies specific to RARP in the early postoperative period have not been reported. Nishida et al demonstrated that urethral mobility at catheter removal predicts early recovery of urinary continence after retropubic and laparoscopic radical prostatectomy 5. Because RARP has a tendency to allow early acquisition of urinary continence compared with retropubic and laparoscopic radical prostatectomies, data on associations between urethral and vesical anatomical features and urinary continence, particularly in RARP, is needed.…”

Novel uroflow stop test at time of catheter removal is a strong predictor of early urinary continence recovery following robotic-assisted radical prostatectomy: A pilot study

“…Few studies reported predictive tools of urine incontinence after RARP . Twiss et al proposed a continence index to determine continence level after removal of the urinary catheter following RARP.…”