Predictors of Early Continence after Robot‐assisted Radical Prostatectomy

Yamada, Yuta; Fujimura, Tetsuya; Fukuhara, Hiroshi; Sugihara, Toru; Nakagawa, Tohru; Kume, Haruki; Igawa, Yasuhiko; Homma, Yukio

doi:10.1111/luts.12181

Cited by 8 publications

(6 citation statements)

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“…Although multiple reports state that the introduction of RARP has led to a general improvement of post-operative symptoms, post-operative LUTS remains an issue of importance [ 11 , 12 ]. We ourselves have conducted several studies to evaluate pre- and post-operative LUTS, especially concerning post-prostatectomy incontinence (PPI) [ 13 , 14 ]. We have reported on the longitudinal change of CLSS and other questionnaires post-RARP and found a short-term worsening of symptoms such as nocturia, urgency urinary incontinence, and stress urinary incontinence [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

The association between the parameters of uroflowmetry and lower urinary tract symptoms in prostate cancer patients after robot-assisted radical prostatectomy

et al. 2022

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Objective To investigate changes in uroflowmetry parameters in men undergoing robot-assisted radical prostatectomy (RARP) for prostate cancer. Materials and methods Four hundred and twenty-eight patients received uroflowmetry testing before and after RARP from November 2011 to December 2018. Clinicopathological data, including age, initial prostate-specific antigen (PSA), prostate volume, clinical stage, body mass index (BMI), uroflowmetry parameters, and core lower urinary tract symptom scores (CLSS) were retrospectively obtained from clinical records. Changes in uroflowmetry parameters were analyzed for statistical predictors and effects on post-operative outcomes. Results A significant increase in maximum flow rate (MFR) and decreases in voided volume (VV) and post-void residual urine (PVR) were seen. In multivariate analysis, age was a negative predictor of MFR increase, while prostate volume was a positive predictor of PVR decrease and MFR increase. VV decrease led to worse incontinence symptoms, while PVR decrease and MFR increase led to improvement in voiding symptoms such as slow stream and straining. Continence recovery curves showed that VV decrease were associated with a delay in continence recovery. Conclusions Significant changes were seen in uroflowmetry results after RARP, each parameter directly related to urinary symptoms. In particular, VV decrease was associated with a worsening of incontinence symptoms and continence recovery.

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Section: Discussionmentioning

confidence: 99%

The association between the parameters of uroflowmetry and lower urinary tract symptoms in prostate cancer patients after robot-assisted radical prostatectomy

et al. 2022

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“…В некоторых публикациях отмечается корреляция индивидуальных особенностей различных структур и образований малого таза с постпростаткэтомической инконтиненцей. Выявлено, что у пациентов с предстательной железой менее 40 см 3 уже в течение первого месяца после операции восстанавливается удержание мочи [23]. В другом исследовании у пациентов с объёмом предстательной железы менее 30 см 3 недержания мочи в постоперационном периоде не отмечались вовсе [24].…”

Section: анатомические особенностиunclassified

Risk factors for urinary incontinence in patients undergoing radical robot-assisted prostatectomy

et al. 2023

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Introduction. Prostate cancer (PCa) is one of the most common cancers among men, and the tactic to treat this disease stage-depends directly. The “gold” standard for localized PCa is radical robot-assisted prostatectomy (RARP). Patients often have excessive surgery requirements and are concerned about the development of postoperative complications. One of the most frequent functional complications after this operation is urinary incontinence (UI), whose formation mechanism is not fully understood. Clinical studies have described many UI predisposing factors, but the results obtained are often contradictory, which requires a repeated and deeper study of the issue.Objective. To identify predisposing factors for urinary incontinence in patients undergoing radical robot-assisted prostatectomy.Materials & methods. The search results for the scientific databases PubMed, Medline, Web of Science, Embase, Cochrane Library and PEDro, Wang-fang Database and CNKI, Edline were analyzed for the queries "robot-assisted prostatectomy", "radical prostatectomy", "incontinence", "predictors", "urinary incontinence".Results. The predisposing factors to UI after RARP were studied. The review discusses and illustrates in detail all known predisposing factors for UI and shows the inconsistency of the data obtained by different researchers, which once again emphasizes the need for further study of this issue.Conclusion. Despite the long history of studying postoperative complications of RARP, reliable and consistent data on all the risks of UI after RARP have not yet been obtained. Therefore, this literature review summarizes and analyzes the results of the latest research in recent years.

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“…Some studies concluded that PV is linked to urinary continence recovery. 26,27 According to Yamada et al, 27 PV independently predicted postoperative urinary incontinence at 1 month post-surgery. By examining 2097 patients, Konety et al 28 recorded lower rates of continence in those with a large prostate size at 6 and 12 months following radical prostatectomy.…”

Section: Continence Rates According To Risk Factorsmentioning

confidence: 99%

“…A high preoperative IPSS is linked to obstruction of the bladder outlet and consequent bladder dysfunction due to BPH. 13,26 Furthermore, BPH may be related to BNP during RARP 27,29 and preservation of the urethra. 19,30 Difficulty in the mobilization of a large prostate in the pelvis complicates the preservation of the neural vascular bundle.…”

Section: Continence Rates According To Risk Factorsmentioning

confidence: 99%

Variations in predictors for urinary continence recovery at different time periods following robot‐assisted radical prostatectomy

Nitta,

Tazawa,

Takahashi

et al. 2023

Asian J Endoscop Surgery

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IntroductionUrinary dysfunctions are common sequelae following prostatectomy. This study aimed to discover factors that can predict urinary continence recovery at various time periods after robot‐assisted laparoscopic radical prostatectomy (RARP).MethodsThis was a retrospective analysis of data of 419 consecutive patients. Only patients followed up for ≥1 year were enrolled. An answer of “zero pad per day” in the Expanded Prostate Cancer Index Composite urinary assessment (question 5) denoted continence. Possible predictors of urinary continence recovery were evaluated at 3, 3–6, and 6–12 months after the operation.ResultsContinence rates at 3, 6, and 12 months after RARP were 12.9%, 21.2%, and 40.2%, respectively. The proportions of patients using 0–1 pad were 54.2%, 75.7%, and 83.1% at 3, 6, and 12 months after RARP, respectively. Multivariable regression analysis revealed that a membranous urethral length (MUL) ≥11 mm was significantly associated with urinary continence recovery both within 3 months (odds ratio: 0.367, P = .003) and 3–6 months (odds ratio: 0.354, P = .001) after RARP. The analysis also revealed that, in patients with urinary continence at 6 months, a large prostate volume (odds ratio: 1.973, P = .044) and a high body mass index (odds ratio: 2.874, P = .027) were negative predictors of urinary continence recovery within 6–12 months.ConclusionA longer MUL was linked to urinary continence recovery within 6 months following RARP, whereas a large prostate volume and a high body mass index were adverse predictors of urinary continence recovery beyond 6 months.

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Predictors of Early Continence after Robot‐assisted Radical Prostatectomy

Abstract: Young age and low pT stage were independent predictors of early continence.

Cited by 8 publications

References 29 publications

The association between the parameters of uroflowmetry and lower urinary tract symptoms in prostate cancer patients after robot-assisted radical prostatectomy

The association between the parameters of uroflowmetry and lower urinary tract symptoms in prostate cancer patients after robot-assisted radical prostatectomy

Risk factors for urinary incontinence in patients undergoing radical robot-assisted prostatectomy

Variations in predictors for urinary continence recovery at different time periods following robot‐assisted radical prostatectomy

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