Factors Affecting Return of Continence 3 Months After Robot-Assisted Radical Prostatectomy: Analysis From a Large, Prospective Data by a Single Surgeon

    Authors

    Y. H. Ko; R. F. Coelho; S. Chauhan; A. Sivaraman; O. Schatloff; J. Cheon;V. R. Patel

    Comments

    Authors: contact us about adding a copy of your work at [email protected]

    Abbreviated Journal Title

    J. Urol.

    Keywords

    urinary incontinence; prostatectomy; URINARY CONTINENCE; RETROPUBIC PROSTATECTOMY; URETHRAL SPHINCTER; OUTCOMES; PRESERVATION; CANCER; IMPACT; MEN; Urology & Nephrology

    Abstract

    Purpose: In this study we identified preoperative or intraoperative factors responsible for the early return of continence after robot-assisted radical prostatectomy using data from a high volume center. Materials and Methods: Data from 1,299 patients who underwent robot-assisted radical prostatectomy performed by a single surgeon from January 2008 to June 2010 were collected prospectively and analyzed retrospectively. Patients were categorized according to whether they regained continence (no pad and no urinary leakage) within 3 months and variables were then compared. A self-administered validated questionnaire (Expanded Prostate Cancer Index Composite) was used for assessment of continence status and time to recovery. Results: Within 3 months after surgery 86.3% of patients (1,121/1,299) had recovered continence. Multivariable Cox regression analysis revealed that only age (p < 0.001, hazard ratio 0.98, 95% CI 0.97-0.99) and performance of a nerve sparing procedure were independent predictors. After adjusting for age, the hazard ratio was 1.61 (95% CI 1.25-2.07, p < 0.001) for partial nerve sparing and 1.44 (1.13-1.83, p = 0.003) for bilateral nerve sparing compared to the nonnerve sparing group. Median time (95% CI) to the recovery of continence was prolonged in the nonnerve sparing group compared to nerve sparing counterparts at 6 (5.12-6.88), 4 (3.60-4.40) and 5 weeks (4.70-5.30) in the nonnerve sparing, partial nerve sparing and bilateral nerve sparing groups, respectively, with log rank p < 0.01. Conclusions: Findings from our analysis indicate that the likelihood of postoperative urinary control was significantly higher in younger patients and when a nerve sparing procedure was performed.

    Journal Title

    Journal of Urology

    Volume

    187

    Issue/Number

    1

    Publication Date

    1-1-2012

    Document Type

    Article

    Language

    English

    First Page

    190

    Last Page

    194

    WOS Identifier

    WOS:000298148000054

    ISSN

    0022-5347

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