A prognostic model for predicting urinary incontinence after robot-assisted radical prostatectomy

Int J Med Robot. 2017 Sep;13(3). doi: 10.1002/rcs.1780. Epub 2016 Sep 27.

Abstract

Background: The aim of this study is to develop a novel prognostic model for estimating the risk of postoperative urinary incontinence (UI) after robot-assisted radical prostatectomy (RARP).

Methods: Participants comprised 131 men who underwent RARP at our hospital from 2011 to 2013. Cox regression analyses were performed to evaluate associations between UI and preoperative factors including filling cystometry and pressure-flow study results and magnetic resonance imaging.

Results: Logistic regression analyses revealed significant associations between membranous urethral length or levator thickness and UI at 3 and 6 months. Stratification produced high (membranous urethral length < 9.5 mm or levator thickness < 9.0 mm) and low (membranous urethral length ≥ 9.5 mm and levator thickness ≥ 9.0 mm) UI risk groups. These inter-group differences in UI rate were significant.

Conclusions: We developed a novel prognostic model based on preoperative patient data that can be used for patient counselling.

Keywords: MRI; cancer; computer assisted surgery; incontinence; prostate; prostatectomy.

MeSH terms

  • Aged
  • Humans
  • Logistic Models
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Postoperative Complications / etiology*
  • Predictive Value of Tests
  • Preoperative Period
  • Prognosis
  • Proportional Hazards Models
  • Prostatectomy / adverse effects*
  • Prostatectomy / methods
  • Prostatic Neoplasms / diagnostic imaging
  • Prostatic Neoplasms / physiopathology
  • Prostatic Neoplasms / surgery*
  • Risk Factors
  • Robotic Surgical Procedures / adverse effects*
  • Robotic Surgical Procedures / methods
  • Urethra / diagnostic imaging
  • Urinary Bladder / physiopathology
  • Urinary Incontinence / diagnostic imaging
  • Urinary Incontinence / etiology*
  • Urinary Incontinence / physiopathology
  • Urinary Tract / diagnostic imaging
  • Urinary Tract / physiopathology