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Predictors of short-term recovery of urinary continence after radical prostatectomy

  • Original Article
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Abstract

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.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical statement

This study was approved by the institutional ethics committee (No. 4381-12). Patients gave written informed consent to record and analyse data. Our study conforms to the provisions of the Declaration of Helsinki revised in Tokyo 2008.

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Authors and Affiliations

  1. Department of Urology, Marienhospital Herne, Ruhr-University Bochum, Widumer Strasse 8, 44627, Herne, Germany

    Jüri R. Palisaar, Florian Roghmann, Marko Brock, Björn Löppenberg, Joachim Noldus & Christian von Bodman

Authors
  1. Jüri R. Palisaar
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  2. Florian Roghmann
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  3. Marko Brock
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  4. Björn Löppenberg
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  5. Joachim Noldus
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  6. Christian von Bodman
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Correspondence to Jüri R. Palisaar.

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Palisaar, J.R., Roghmann, F., Brock, M. et al. Predictors of short-term recovery of urinary continence after radical prostatectomy. World J Urol 33, 771–779 (2015). https://doi.org/10.1007/s00345-014-1340-3

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  • DOI: https://doi.org/10.1007/s00345-014-1340-3

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