Use of preoperative factors including urodynamic evaluations and nerve‐sparing status for predicting urinary continence recovery after robot‐assisted radical prostatectomy: Nerve‐sparing technique contributes to the reduction of postprostatectomy incontinence

Abstract

Preoperative factors, including the results of UDS, could not predict continence 1 year after RARP. The NS procedure contributed to continence status. NS favorably affected MUCP and FUL; however, it did not affect bladder function after RARP. Neurourol. Urodynam. 35:1034-1039, 2016. © 2015 Wiley Periodicals, Inc.

Preoperative Membranous Urethral Length Measurement and Continence Recovery Following Radical Prostatectomy: A Systematic Review and Meta-analysis

“…A total of 1738 patients (780 RRP, 937 RARP, and 21 laparoscopies [LP]) were included in the four studies reporting the hazard ratio for the recovery of continence [20,22,24,26]. For the study reporting the OR of a return to continence at 1 mo, a total of 872 patients (416 RRP and 456 RARP) were included [18], for the studies at 3 mo 2517 patients (571 RRP, 1697 RARP, and 249 LP) were included [14,19,21,22,25,26], at 6 mo 3187 patients (1667 RRP, 589 RARP, and 931 LP) were included [14,16,26], and at 12 mo 4656 patients (2555 RRP, 998 RARP, and 1103 LP) were included [15–18,23,26]. …”

“…MRI examinations were performed with the patient positioned in the supine position using 1.5T or 3T MRI units acquiring T2-weighted images which were used for MUL measurements. The use of an endorectal coil was used in four studies [16,21,24,26], not used in four studies [14,22,23,25], and not reported in five studies [15,17–20]. MUL was measured in either: (1) the coronal plane in six studies [16,19–21,25,26], (2) the sagittal plane in three studies [14,17,22], (3) the sagittal plane cross-referenced with the coronal plane in two studies [23,24], and (4) not reported in two studies [15,18].…”

“…Eight studies used pad-free status or the use of a security liner [14,16,18,21–25], two studies defined continence as 0–1 pad use [19,20], and two studies used a patient report of complete continence [17,26]. There was only one study [15] that used a 24-h pad test to define continence with a strict definition applied (pad weight gain not exceeding a mean of 2 g/d for 3 consecutive d).…”

“…The number of studies reporting the MUL related odds for the return to continence at 3 mo ( n = 6) [14,19,21,22,25,26] and 12 mo ( n = 6) [15–18,23,26] permitted the meta-analyses by subgroupings within each of these three factors of interest. For continence definition (pad free, 0–1 pad, 24-h pad test, or no complaint of incontinence) the results are mixed and the MUL odds of return to continence at 3 mo or 12 mo is not related to continence definition (Supplementary Figs.…”

Surgical Techniques to Optimize Early Urinary Continence Recovery Post Robot Assisted Radical Prostatectomy for Prostate Cancer

“…This has been physiologically shown by Nelson et al [18] who measured changes in the intraurethral pressure caused by intraoperative NVB stimulation and noted an increase in pressure on NVB stimulation. Kadono et al [19] performed urodynamic measurements pre-op, immediately after op, and 1 year after RARP and demonstrated that recovery patterns of storage and voiding functions were the same among non-NVB, unilateral-NVB, and bilateral NVB groups and that higher degrees of NVB preservation contributed to lesser decreases in MUCP and longer functional urethral length (FUL) after RARP.…”