Postoperative Cystogram Findings Predict Incontinence Following Robot-Assisted Radical Prostatectomy

Olgin, Gaudencio; Alsyouf, Muhannad; Han, D.H.; Li, Roger; Lightfoot, Michelle; Smith, Damien; Nicolay, Lesli I.; Ruckle, Herbert C.; Baldwin, D. Duane

doi:10.1089/end.2014.0236

Cited by 28 publications

(30 citation statements)

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“…Several physicians have reported the significant correlation between the postoperative cystogram findings and urinary continence after radical prostatectomy . Olgin et al reported an association between the post‐prostatectomy bladder neck location, defined by the bladder neck to the pubic symphysis (BNPS) ratio, and urinary continence at both 3 and 12 months. They concluded that the bladder neck location and urinary continence after RALP were significantly correlated.…”

Section: Discussionmentioning

confidence: 99%

“…They concluded that the bladder neck location and urinary continence after RALP were significantly correlated. Ha et al also reported the correlation between the bladder neck location and urinary continence using the BNPS ratio defined by Olgin . They concluded that the BNPS ratio was shown to be an independent predictive factor for urinary continence at 3 months after radical prostatectomy.…”

Section: Discussionmentioning

confidence: 99%

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Postoperative cystogram findings predict recovery of urinary continence after robot‐assisted laparoscopic radical prostatectomy

Fukui

Kagebayashi

Iemura

et al. 2019

LUTS

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Objectives: To assess the association between postoperative cystogram findings and subsequent outcomes on urinary continence after robot-assisted laparoscopic radical prostatectomy (RALP).Methods: A retrospective review of 250 consecutive patients who were observed for at least 12 months after RALP. The postoperative cystogram findings examined were: the location of the bladder neck, degree of bladder abnormalities, and presence of outflow of contrast medium into the urethra during the filling phase of cystography. The continence status based on pad usage was recorded. Those who required no pad or only a safety pad were defined as continent.Results: Patients with a bladder neck location above the middle of the pubic symphysis height exhibited significantly higher continence levels than those with a lower bladder neck location at both postoperative 3 and 12 months (P < 0.0001 and P = 0.0002, respectively). The higher a bladder neck was located, the earlier the urinary continence was achieved after RALP (P < 0.0001). Patients without contrast outflow into the urethra during cystogram demonstrated a significantly more favorable continence status at the 3-month follow-up (P = 0.004). Patients without bladder abnormalities on postoperative cystogram demonstrated a significantly more favorable continence status at the 12-month follow-up than those with bladder abnormalities (P = 0.01).Conclusions: Postoperative cystogram findings may predict recovery of urinary continence after RALP. K E Y W O R D S bladder neck, cystogram, prostatectomy, RALP, urinary incontinence 1 | INTRODUCTION The spread of prostate serum antigen (PSA) screening has increased the reported incidence of prostate cancer. Robot-assisted laparoscopic radical prostatectomy (RALP) has become the most common surgical management for prostate cancer. It was reported that 85% of prostatectomies were performed under robotic surgery in the USA in 2009. 1 Although surgical techniques have improved, urinary inconti-nence is one of the most common complications following prostatectomy and has a significant impact on the quality of life (QoL) of patients who undergo radical prostatectomy. The reported incidence of patients with urinary incontinence after radical prostatectomy ranges from 6% to 20%. 2,3 Although nearly 90% of patients achieved urinary continence at the 12-month follow-up following prostatectomy, the incidence of urinary incontinence did not improve remarkably later than 12 months after prostatectomy. 4The pathophysiology of urinary incontinence after RALP has been investigated, and multiple factors are associated with urinary incontinence after prostatectomy, including damage to the urinary sphincter, 5 bladder neck dysfunction, 6 and dysfunction of the pelvic diaphragm. 6In this study, we assessed the association between the postoperative cystogram findings and subsequent urinary continence outcomes to identify factors that predict postoperative urinary incontinence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Postoperative cystogram findings predict recovery of urinary continence after robot‐assisted laparoscopic radical prostatectomy

Fukui

Kagebayashi

Iemura

et al. 2019

LUTS

View full text Add to dashboard Cite

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“…The BNPS ratio in the cystogram has been used to define the bladder neck location and to predict postoperative continence. Olgin et al, first descript the measured method with BNPS in prediction of postoperative continence in patient received radical prostatectomy and reported the continence rate of the lowes BNPS (mean 0.16), intermediate BNPS (mean 0.41) and high BNPS (mean 0.70) group were 80.3%, 72.7% and 59.7%, respectively (8). Our results also confirm the predictive value of the cystogram in the unimultivariate analysis model and this may be used as a tool to predict functional outcome or evaluated anatomic condition of pelvic floor.…”

Section: Discussionmentioning

confidence: 99%

“…The efficacy of the bladder neck to pubic symphysis (BNPS) ratio in predicting postoperative continence after radical prostatectomy was described and the lower BNPS ratio was associated with a better early continence outcome (8).…”

mentioning

confidence: 99%

Retzius-sparing Robotic-assisted Radical Prostatectomy Associated with Less Bladder Neck Descent and Better Early Continence Outcome

Chang

Hung

et al. 2018

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“…To identify predictive factors for urinary continence, it was divided into two categories: early continence ( < 3 months) and late continence ( > 12 months) [26].…”

Section: Discussionmentioning

confidence: 99%

Urinary continence outcomes of four years of follow-up and predictors of early and late urinary continence in patients undergoing robot-assisted radical prostatectomy

Zhang

Jia

et al. 2019

Preprint

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Background: Although the wide application of robot-assisted radical prostatectomy (RARP) in recent years, studies about long urinary continence were few. In this study, we aimed to examine the outcomes of continence rates (CRs) and determine the risk and protective factors of early and late urinary continence in patients with prostate cancer (PCa) undergoing RARP. Methods: This retrospective study included 650 patients treated with RARP who completed perioperative data and at least one year of follow-up from January 2009 to November 2017. We analyzed the preoperative, intraoperative, and postoperative parameters of the patients. Continence was defined as no pad use.CRs from one to 48 months postoperatively were examined. Logistic regression analysis was performed to evaluate the associations between the predictive factors and urinary continence in the early and late stages. Results: CRs of the patients at one, three, six, 12, 24, 36, and 48 months postoperatively were 40.62%, 60.92%, 71.38%, 78.77%, 79.96%, 79.51%, and 76.50%, respectively.There were no significant differences in CR from 12 to 48 months postoperatively (P=0.766). Logistic regression analysis proved that pelvic lymph node dissection (PLND) was a significant risk factor of urinary continence at one month. Nerve sparing (NS) was a significant protective factor of urinary continence at one, three and six months. Age was an independent risk factor of urinary continence at six, 12 and 24 months. Other variables were not statistically significant predictors. Conclusions: Our results demonstrated that CR gradually improved with time within one year and stabilized one year after the surgery. PLND, NS and age were significant determinants of continence in the early and late stages, respectively. These parameters could be used for preoperatively identifying patients at high risk for urinary incontinence and counselling about postoperative expectations for urinary continence. BackgroundDespite advances in surgical technique and methodology, postprostatectomy urinary incontinence (UI) remains a significant adverse event that leads to decreased quality of life [1,2]. It has been suggested that a number of factors are involved in recovery of urinary continence after radical prostatectomy (RP) [3,4]. Many patients have learned about this disease from the media. Hence, it is necessary to predict recovery of urinary continence early to minimize patients' concerns and

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Postoperative Cystogram Findings Predict Incontinence Following Robot-Assisted Radical Prostatectomy

Cited by 28 publications

References 10 publications

Postoperative cystogram findings predict recovery of urinary continence after robot‐assisted laparoscopic radical prostatectomy

Postoperative cystogram findings predict recovery of urinary continence after robot‐assisted laparoscopic radical prostatectomy

Retzius-sparing Robotic-assisted Radical Prostatectomy Associated with Less Bladder Neck Descent and Better Early Continence Outcome

Urinary continence outcomes of four years of follow-up and predictors of early and late urinary continence in patients undergoing robot-assisted radical prostatectomy

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