TY - JOUR
T1 - Factors predicting continence recovery 1month after radical prostatectomy
T2 - Results of a multicenter survey
AU - Gacci, Mauro
AU - Carini, Marco
AU - Simonato, Alchiede
AU - Imbimbo, Ciro
AU - Gontero, Paolo
AU - Briganti, Alberto
AU - De Cobelli, Ottavio
AU - Fulcoli, Vittorio
AU - Martorana, Giuseppe
AU - Nicita, Giulio
AU - Mirone, Vincenzo
AU - Carmignani, Giorgio
PY - 2011/10
Y1 - 2011/10
N2 - Objectives: To assess the factors associated with continence recovery 1month after radical prostatectomy (RP) and to identify the correlation between these factors. Methods: In total, 2408 men treated with RP for prostate cancer (PCa) were enrolled in the present multicenter prospective study. Clinical (age, body mass index) and urological (catheterization or transurethral resection of the prostate) records, quality of life (QOL) scores determined using various instruments (including the International Index of Erectile Function [IIEF] and University of California Los Angeles, Prostate Cancer Index [UCLA-PCI]), PCa characteristics (clinical stage [cT], prostate-specific antigen, biopsy Gleason score), surgical features (surgical approach, nerve and bladder neck sparing, catheterization), and pathologic outcomes (pT, pN+, Gleason score, positive surgical margins) were recorded. Continence status prior to surgery and at 1month after RP was assessed and classified as followed: (i) full continence; (ii) 0-1 pads/day; or (iii) >1 pad/day. Only patients determined to have full continence prior to surgery were included in the analysis. Data were evaluated using Spearman's correlation analysis and multivariate logistic regression. Results: Data from 1972 patients with full continence preoperatively and complete postoperative data were analyzed. At 1month after RP, 644 patients (32.7%) were fully continent, 810 (41.1%) were using 0-1 pads/day, and 518 (26.3%) were using >1 pad/day. Univariate analysis indicated that clinical and urological data, QOL, PCa characteristics, surgical features, and pathologic outcomes were determinants for continence recovery. Multivariate analysis indicated that preoperative sexual activity (UCLA-PCI Sexual Function P=0.005; IIEF P=0.040), bladder neck sparing (P=0.003), catheterization time (P=0.007), and catheter diameter (P=0.046) were associated with 1month continence recovery. Conclusions: Age and nerve sparing are not significant predictors of continence recovery 1month after RP. Preoperative erectile function can predict post-prostatectomy incontinence. Bladder neck preservation has a significant effect on early continence recovery after RP.
AB - Objectives: To assess the factors associated with continence recovery 1month after radical prostatectomy (RP) and to identify the correlation between these factors. Methods: In total, 2408 men treated with RP for prostate cancer (PCa) were enrolled in the present multicenter prospective study. Clinical (age, body mass index) and urological (catheterization or transurethral resection of the prostate) records, quality of life (QOL) scores determined using various instruments (including the International Index of Erectile Function [IIEF] and University of California Los Angeles, Prostate Cancer Index [UCLA-PCI]), PCa characteristics (clinical stage [cT], prostate-specific antigen, biopsy Gleason score), surgical features (surgical approach, nerve and bladder neck sparing, catheterization), and pathologic outcomes (pT, pN+, Gleason score, positive surgical margins) were recorded. Continence status prior to surgery and at 1month after RP was assessed and classified as followed: (i) full continence; (ii) 0-1 pads/day; or (iii) >1 pad/day. Only patients determined to have full continence prior to surgery were included in the analysis. Data were evaluated using Spearman's correlation analysis and multivariate logistic regression. Results: Data from 1972 patients with full continence preoperatively and complete postoperative data were analyzed. At 1month after RP, 644 patients (32.7%) were fully continent, 810 (41.1%) were using 0-1 pads/day, and 518 (26.3%) were using >1 pad/day. Univariate analysis indicated that clinical and urological data, QOL, PCa characteristics, surgical features, and pathologic outcomes were determinants for continence recovery. Multivariate analysis indicated that preoperative sexual activity (UCLA-PCI Sexual Function P=0.005; IIEF P=0.040), bladder neck sparing (P=0.003), catheterization time (P=0.007), and catheter diameter (P=0.046) were associated with 1month continence recovery. Conclusions: Age and nerve sparing are not significant predictors of continence recovery 1month after RP. Preoperative erectile function can predict post-prostatectomy incontinence. Bladder neck preservation has a significant effect on early continence recovery after RP.
KW - Bladder neck
KW - Nerve sparing
KW - Prostate cancer
KW - Prostatectomy
KW - Urinary continence
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U2 - 10.1111/j.1442-2042.2011.02826.x
DO - 10.1111/j.1442-2042.2011.02826.x
M3 - Article
C2 - 21834853
AN - SCOPUS:80053110733
VL - 18
SP - 700
EP - 708
JO - International Journal of Urology
JF - International Journal of Urology
SN - 0919-8172
IS - 10
ER -