Simple and reliable predictor of urinary continence after radical prostatectomy: Serial measurement of urine loss ratio after catheter removal

Abstract

Abbreviations & Acronyms LRP = laparoscopic radical prostatectomy NS = nerve sparing OT = operation time PSA = prostate-specific antigen RARP = robotic assisted radical prostatectomy RP = radical prostatectomy RRP = retropubic radical prostatectomy UCLA-PCI = University of California, Los Angeles Prostate Cancer Index UF = urinary function UI = urinary incontinence ULR = urine loss ratio ULV = urine loss volume Objectives: To evaluate urine loss ratio after catheter removal as a predictive factor of urinary continence after radical prostatectomy. Methods: A total of 190 patients who had undergone retropubic radical prostatectomy were evaluated. Urine loss ratio was measured using the 24-h pad test during 7 consecutive days after removal of urethral catheters. Continence rates at 1, 3, 6 and 12 months after operation were evaluated with the urinary function domain of the University of California, Los Angeles Prostate Cancer Index. The desirable urine loss ratio for continent condition at 12 months after the operation was calculated. As desirable target urine loss ratio continence at 12 months was determined by using logistic analysis. Results: Continence rates of all patients at 1, 3, 6 and 12 months after surgery were 13%, 37.8%, 58.9%, and 85.8%, respectively. Continence rates of patients who achieved ≤1% of urine loss ratio within 7 days or ≤5% urine loss ratio within 3 days after catheter removal was 100% at 12 months. Logistic regression analysis proved these urine loss ratio values were significant predictors of continence at 12 months. Conclusions: Urine loss ratio after catheter removal within 7 days is a significant determinant of urinary continence after radical prostatectomy. This parameter could have clinical usefulness to estimate future recovery of urinary continence.

Practical Index of Urinary Incontinence Following Holmium Laser Enucleation of the Prostate: A Case-Series Study of the 24-Hour Pad Test Immediately after Catheter Removal

“…In agreement with previous studies conducted after radical prostatectomy for prostate cancer [16,17,18,19], our present study demonstrated that the results of a pad test conducted immediately after post-HoLEP catheter removal correlated with postoperative continence acquisition, regardless of the catheterization status at the time of surgery, and revealed that the pad test is a practical secondary prevention measure of PFMT. In our study, the UI amount measured during the immediately postoperative 24-hour pad test was examined using a cut-off value of 0 g, the most frequent value.…”

“…Regarding radical prostatectomy for prostate cancer, which causes similar problems with postoperative continence, urine leakage is checked immediately after postoperative catheter removal using the pad test and has been reported as a prognosticator of recovery from incontinence [16,17,18,19]; in contrast, no such studies have been conducted among patients who have undergone HoLEP. In this study, we examined whether the amount of urine leakage on day 1 following catheter removal might also be a prognosticator of incontinence after HoLEP.…”

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

“…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 embarrassment [5].…”

Editorial Comment to Simple and reliable predictor of urinary continence after radical prostatectomy: Serial measurement of urine loss ratio after catheter removal

“…In the present study, Sato et al . made an effort to assess urine loss ratio after catheter removal as a predictive factor for future urinary continence in a cohort of 190 patients after retropubic radical prostatectomy, and showed that urine loss ratio within 7 days was a significant determinant of urinary continence at 12 months after surgery . Herein, urine loss ratio could have clinical usefulness to estimate future recovery of urinary continence.…”