Urinary Continence after Robot-Assisted Laparoscopic Radical Prostatectomy: The Impact of Intravesical Prostatic Protrusion.
10.3349/ymj.2016.57.5.1145
- Author:
Jung Ki JO
1
;
Sung Kyu HONG
;
Seok Soo BYUN
;
Homayoun ZARGAR
;
Riccardo AUTORINO
;
Sang Eun LEE
Author Information
1. Department of Urology, Hanyang University Hospital, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Continence;
intravesical prostatic protrusion;
robot assisted radical prostatectomy;
transrectal ultrasonography
- MeSH:
Aged, 80 and over;
Humans;
Laparoscopy/methods;
Magnetic Resonance Imaging;
Male;
Middle Aged;
Multivariate Analysis;
Postoperative Complications/etiology;
Prostatectomy/*methods;
Prostatic Neoplasms/complications/*surgery;
*Recovery of Function;
*Robotic Surgical Procedures;
Urinary Bladder Neck Obstruction/*diagnostic imaging/etiology;
*Urination
- From:Yonsei Medical Journal
2016;57(5):1145-1151
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To assess the impact of intravesical prostatic protrusion (IPP) on the outcomes of robot-assisted laparoscopic prostatectomy (RALP). MATERIALS AND METHODS: The medical records of 1094 men who underwent RALP from January 2007 to March 2013 were analyzed using our database to identify 641 additional men without IPP (non-IPP group). We excluded 259 patients who presented insufficient data and 14 patients who did not have an MRI image. We compared the following parameters: preoperative transrectal ultrasound, prostate specific antigen (PSA), clinicopathologic characteristics, intraoperative characteristics, postoperative oncologic characteristics, minor and major postoperative complications, and continence until postoperative 1 year. IPP grade was stratified by grade into three groups: Grade 1 (IPP≤5 mm), Grade 2 (5 mm10 mm). RESULTS: Of the 821 patients who underwent RALP, 557 (67.8%) experienced continence at postoperative 3 months, 681 (82.9%) at 6 months, and 757 (92.2%) at 12 months. According to IPP grade, there were significant differences in recovering full continence at postoperative 3 months, 6 months, and 12 months (p<0.001). On multivariate analysis, IPP was the most powerful predictor of postoperative continence in patients who underwent RALP (p<0.001). Using a generalized estimating equation model, IPP also was shown to be the most powerful independent variable for postoperative continence in patients who underwent RALP (p<0.001). CONCLUSION: Patients with low-grade IPP have significantly higher chances of recovering full continence. Therefore, the known IPP grade will be helpful during consultations with patients before RALP.
