4.3 Article

Predictors of urinary function recovery after laparoscopic and robot-assisted radical prostatectomy

Journal

INTERNATIONAL BRAZ J UROL
Volume 49, Issue 1, Pages 50-60

Publisher

BRAZILIAN SOC UROL
DOI: 10.1590/S1677-5538.IBJU.2022.0362

Keywords

Prostatic Neoplasms; Robotic Surgical Procedures; Urinary Incontinence

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The aim of this study was to identify predictors of urinary continence recovery among patients with urinary incontinence immediately after surgery. The study found that age and intraoperative blood loss were predictors affecting urinary continence recovery one year after surgery. Younger patients and those with higher intraoperative blood loss can recover urinary continence one year after surgery.
Introduction: Even in the era of laparoscopic radical prostatectomy (LRP) and robot--assistedlaparoscopic radical prostatectomy (RALP), we sometimes encounter patients with severe urinary incontinence after surgery. The aim of the present study was to identify predictors of urinary continence recovery among patients with urinary incon-tinence immediately after surgery (UIIAS).Materials and Methods: We identified 274 patients with clinically localized prostate cancer who underwent LRP and RALP between 2011 and 2018. UIIAS was defined as a urine loss ratio > 0.15 on the first day of urethral catheter removal. Urinary continence recovery was defined as using <= 1 pad/day one year after surgery. In the present study, we evaluated factors affecting urinary function recovery one year after surgery among patients with urinary incontinence immediately after LRP and RALP.Results: UIIAS was observed in 191 out of 274 patients (69.7%). A multivariate analysis identified age (< 65 years, p = 0.015) as an independent predictor affecting immediate urinary continence. Among 191 incontinent patients, urinary continence one year after surgery improved in 153 (80.1%). A multivariate analysis identified age (< 65 years, p = 0.003) and estimated blood loss (>= 100 mL, p = 0.044) as independent predictors affecting urinary continence recovery one year after surgery.Conclusion: The present results suggest that younger patients and patients with higher intraoperative blood loss recover urinary continence one year after surgery even if they are incontinent immediately after surgery.

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