PURPOSE: To evaluate treatment variables for early urinary continence status 6 weeks following radical prostatectomy.
METHODS: In this retrospective analysis, 4,028 consecutive patients underwent open radical retropubic (RRP) or robot-assisted transperitoneal prostatectomy (RARP) at a single academic institution (07/2003-07/2013). After discharge, patients were offered 3-week treatment in a rehabilitation facility. Patients who opted for rehabilitation (n = 2,998, 74.4 %) represent our study cohort. Exclusion criteria were acute urinary retention after catheter removal (n = 55, 1.4 %), incomplete datasets (n = 50, 1.2 %) or refusal of rehabilitation (n = 925, 23.0 %). Results of urinary continence were evaluated from final rehabilitation reports. Twenty-two clinical and oncological variables were statistically analysed in uni- and multivariable analyses to determine whether they were associated with early urinary continence status six weeks after radical prostatectomy. Odds ratios and 95 % CI as well as p values were calculated. A p level of 0.05 was considered as significant.
RESULTS: Six weeks after surgery, 1,962 (65.4 %) patients were continent (≤ 1 pad/day) and 1,036 (34.6 %) patients were considered incontinent. Age, clinical stage, PSA, ASA score, prior TURP, seminal vesicle invasion, Gleason score, nerve-sparing status, intraoperative blood loss, catheterisation time, OR time, surgical caseload >1,000 and the surgeon were associated with continence status on univariable analysis (p < 0.05). On multivariable analysis, nerve-sparing procedure (NS), clinical stage, individual surgeon, patient age, surgical procedure (RARP vs. RRP) and duration of catheterisation were independent predictors (p < 0.05) of incontinence status.
CONCLUSIONS: Strategies that can ensure NS procedures and early catheter removal should be applied to enable early recovery of urinary continence.
Written by:
Palisaar JR, Roghmann F, Brock M, Löppenberg B, Noldus J, von Bodman C. Are you the author?
Department of Urology, Marienhospital Herne, Ruhr-University Bochum, Widumer Strasse 8, 44627, Herne, Germany.
Reference: World J Urol. 2014 Jun 14. Epub ahead of print.
doi: 10.1007/s00345-014-1340-3
PubMed Abstract
PMID: 24928375
UroToday.com Urinary Incontinence Section
