Incontinence after robot-assisted radical prostatectomy (RARP) is feared by most patients with prostate cancer. Many risk factors for incontinence after RARP are known, but a paucity of data integrates them. Prospectively acquired data from 680 men who underwent RARP January 2008–December 2015 and met inclusion/exclusion criteria were queried retrospectively and then divided into model development (80%) and validation (20%) cohorts. The UCLA-PCI-Short Form-v2 Urinary Function questionnaire was used to categorize perfect continence (0 pads), social continence (1–2 pads), or incontinence (≥3 pads). The observed incontinence rates were 26% at 6 months, 7% at 12 months, and 3% at 24 months. Logistic regression was used for model development, with variables identified using a backward selection process. Variables found predictive included age, race, body mass index, and preoperative erectile function. Internal validation and calibration were performed using standard bootstrap methodology. Calibration plots and receiver operating curves were used to evaluate model performance. The initial model had 6-, 12-, and 24-month areas under the curves (AUCs) of 0.64, 0.66, and 0.80, respectively. The recalibrated model had 6-, 12-, and 24-month AUCs of 0.52, 0.52, and 0.76, respectively. The final model was superior to any single clinical variable for predicting the risk of incontinence after RARP.

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IR in acute cystitis group did not show significant difference when compared with group A (p>0.05). In chronic cystitis group, p-CREB-IR in the L1-L6 and S1 DRG was significantly greater than control (p<0.05), and p-CREB-IR in the L3-L6 and S1 DRG was significantly greater than that in acute cystitis group (p<0.05). In control and acute cystitis group, p-CREB-IR in the L4-L5 DRG was significantly smaller than the other DRGs (p<0.05). p-CREB-IR in the L6 and S1 DRG was significantly greater than L4-L5 DRG among chronic cystitis group (p<0.05).CONCLUSIONS: We observed the changes in the immunoreactivity of p-CREB in lumbosacral DRG cells after acute (single) or chronic (once a week for 4 weeks) E.coli cystitis. Especially, chronic E.coli infection up-regulated p-CREB expression in L1-L6 and S1 DRG, which means that the involvement of bladder afferent neurons cause its pathologic change. Under repetitive infection, p-CREB expression in DRG cells may be related to changes in bladder-originated factors influencing on micturition reflex pathways.

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