Title

Factors Affecting Return Of Continence 3 Months After Robot-Assisted Radical Prostatectomy: Analysis From A Large, Prospective Data By A Single Surgeon

Keywords

prostatectomy; urinary incontinence

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 0.970.99) and performance of a nerve sparing procedure were independent predictors. After adjusting for age, the hazard ratio was 1.61 (95% CI 1.252.07, p <0.001) for partial nerve sparing and 1.44 (1.131.83, 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 (5.126.88), 4 (3.604.40) and 5 weeks (4.705.30) 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. © 2012 American Urological Association Education and Research, Inc.

Publication Date

1-1-2012

Publication Title

Journal of Urology

Volume

187

Issue

1

Number of Pages

190-195

Document Type

Article

Personal Identifier

scopus

DOI Link

https://doi.org/10.1016/j.juro.2011.09.037

Socpus ID

83555172656 (Scopus)

Source API URL

https://api.elsevier.com/content/abstract/scopus_id/83555172656

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