Perioperative predictors for post-prostatectomy urinary incontinence in prostate cancer patients following robotic-assisted radical prostatectomy: Long-term results of a Canadian prospective cohort

Authors

  • Emad Rajih Taibah University
  • Malek Meskawi University de Montreal
  • Abdullah M. Alenizi University de Montreal
  • Kevin C. Zorn University de Montreal
  • Mansour Alnazari University de Montreal
  • Marc Zanaty University de Montreal
  • Naif Alhathal
  • Assaad El-Hakim University de Montreal

DOI:

https://doi.org/10.5489/cuaj.5356

Keywords:

post-prostatectomy, urinary incontinence, prostate cancer, RARP

Abstract

Introduction: We aimed to report the impact of perioperative factors that have not been well-studied on continence recovery following robotic-assisted radical prostatectomy (RARP).

Methods: We analyzed data of 322 men with localized prostate cancer who underwent RARP between October 2006 and May 2015 in a single Canadian centre. All patients were assessed at one, three, six, 12, and 24 months after surgery. We evaluated risk factors for post-prostatectomy urinary incontinence from a prospectively collected database in multivariate Cox regression analysis. The primary endpoint was continence, defined as 0 pad usage per day.

Results: 0-pad continence rates were 126/322 (39%), 187/321 (58%), 222/312 (71%), 238/294 (80%), and 233/257 (91%) at one, three, six, 12, and 24 months, respectively. Bladder neck preservation (hazard ratio [HR] 0.71; 95% confidence interval [CI] 0.5–0.99; p=0.04), and prostate size (HR 0.99; 95% CI 0.98–0.99; p=0.02) were independent predictors of continence recovery after RARP. Smoking at time of surgery predicted delayed continence recovery on multivariate analysis (HR 1.42; 95% CI 1.01–1.99; p=0.04). Neurovascular bundles preservation was associated with continence recovery after 24 months. No statistically significant correlation was found with other variables, such as age, body mass index, Charlson comorbidity index, preoperative oncological baseline parameters, presence of median lobe, or thermal energy use.

Conclusions: Our results confirmed known predictors of postprostatectomy incontinence (PPI), namely bladder neck resection and large prostate volume. Noteworthy, cigarette smoking at the time of RARP was found to be a possible independent risk factor for PPI. This study is hypothesis-generating.

Downloads

Download data is not yet available.

Published

2018-10-15

How to Cite

Rajih, E., Meskawi, M., Alenizi, A. M., Zorn, K. C., Alnazari, M., Zanaty, M., Alhathal, N., & El-Hakim, A. (2018). Perioperative predictors for post-prostatectomy urinary incontinence in prostate cancer patients following robotic-assisted radical prostatectomy: Long-term results of a Canadian prospective cohort. Canadian Urological Association Journal, 13(5). https://doi.org/10.5489/cuaj.5356

Issue

Section

Original Research

Similar Articles

You may also start an advanced similarity search for this article.