Objectives: To assess the preoperative urodynamic predictors of urinary incontinence (UI) 1 year after robot-assisted radical prostatectomy (RARP) and to design a nomogram capable of predicting its occurrence.
Materials and Methods: Our prospective study included 58 previously continent patients who underwent RARP, in most cases, bilateral nerve-sparing and bladder neck preservation. A urodynamic examination including a urethral pressure profile was performed preoperatively. Multivariate analysis was used to assess the predictors for the need to use 1 or more pads/day and a nomogram was constructed.
Results: There was a 20.6% incidence of UI at 1 year after RARP. Bladder compliance, maximum urethral closure pressure and the development of bladder outlet obstruction, correlated well with the incidence of UI on the multivariate analysis (p = 0.043, 0.001, and 0.05, respectively).
Conclusion: Bladder compliance < 27.8 ml/cm H2O, maximum urethral closure pressure < 50.3 cm H2O and the bladder outlet obstruction are independent urodynamic factors correlating with UI after RARP. The new nomogram can objectively predict a patient likelihood of requiring 1 or more pads/day 1 year after RARP with a good accuracy.
Written by:
Barnoiu OS, Garcia Galisteo E, Baron Lopez F, Vozmediano Chicharro R, Soler Martinez J, Del Rosal Samaniego JM, Machuca Santacruz J, Baena Gonzalez V. Are you the author?
Department of Urology, Carlos Haya Hospital, Malaga, Spain.
Reference: Urol Int. 2013 Dec 5. Epub ahead of print.
doi: 10.1159/000354352
PubMed Abstract
PMID: 24334874
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