Factors predicting continence recovery 1month after radical prostatectomy: Results of a multicenter survey

Mauro Gacci, Marco Carini, Alchiede Simonato, Ciro Imbimbo, Paolo Gontero, Alberto Briganti, Ottavio De Cobelli, Vittorio Fulcoli, Giuseppe Martorana, Giulio Nicita, Vincenzo Mirone, Giorgio Carmignani

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)700-708
Number of pages9
JournalInternational Journal of Urology
Volume18
Issue number10
DOIs
Publication statusPublished - Oct 2011

Keywords

  • Bladder neck
  • Nerve sparing
  • Prostate cancer
  • Prostatectomy
  • Urinary continence

ASJC Scopus subject areas

  • Urology

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    Gacci, M., Carini, M., Simonato, A., Imbimbo, C., Gontero, P., Briganti, A., De Cobelli, O., Fulcoli, V., Martorana, G., Nicita, G., Mirone, V., & Carmignani, G. (2011). Factors predicting continence recovery 1month after radical prostatectomy: Results of a multicenter survey. International Journal of Urology, 18(10), 700-708. https://doi.org/10.1111/j.1442-2042.2011.02826.x