Mp52-08 Correlation Between Early Recovery of Urinary Continence and Length of Spared Urethra After Robotic Assisted Radical Prostatectomy: A Prospective Multicenter Study

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy II (MP52)1 May 2024MP52-08 CORRELATION BETWEEN EARLY RECOVERY OF URINARY CONTINENCE AND LENGTH OF SPARED URETHRA AFTER ROBOTIC ASSISTED RADICAL PROSTATECTOMY: A PROSPECTIVE MULTICENTER STUDY Fabio Maria Valenzi, Antonio Luigi Pastore, Andrea Fuschi, Yazan Al Salhi, Paolo Pietro Suraci, Silvio Scalzo, Alice Antonioni, Onofrio Antonio Rera, Manfredi Bruno Sequi, Damiano Graziani, Filippo Gianfrancesco, Giorgio Martino, Giuseppe Candita, Alessandro Sciarra, Martina Moriconi, Cosimo De Nunzio, Giorgia Tema, Alessandro Zucchi, Matteo Pacini, and Antonio Carbone Fabio Maria ValenziFabio Maria Valenzi , Antonio Luigi PastoreAntonio Luigi Pastore , Andrea FuschiAndrea Fuschi , Yazan Al SalhiYazan Al Salhi , Paolo Pietro SuraciPaolo Pietro Suraci , Silvio ScalzoSilvio Scalzo , Alice AntonioniAlice Antonioni , Onofrio Antonio ReraOnofrio Antonio Rera , Manfredi Bruno SequiManfredi Bruno Sequi , Damiano GrazianiDamiano Graziani , Filippo GianfrancescoFilippo Gianfrancesco , Giorgio MartinoGiorgio Martino , Giuseppe CanditaGiuseppe Candita , Alessandro SciarraAlessandro Sciarra , Martina MoriconiMartina Moriconi , Cosimo De NunzioCosimo De Nunzio , Giorgia TemaGiorgia Tema , Alessandro ZucchiAlessandro Zucchi , Matteo PaciniMatteo Pacini , and Antonio CarboneAntonio Carbone View All Author Informationhttps://doi.org/10.1097/01.JU.0001008864.84854.b7.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urinary incontinence (UI) is considered one of the main complications of radical prostatectomy and can significantly affects patients' quality of life. Different characteristics of the urethra have been proved to be significant to obtain an early urinary continence following radical prostatectomy. The aim of the study was to correlate the length of the spared urethra in patients undergoing robotic radical prostatectomy (RALP) with the rates of early recovery (90 days postop) of urinary continence. METHODS: This multicenter prospective study enrolled patients affected by prostate cancer undergoing interfascial nerve-sparing RALP. None of the patients had preoperative UI at urodynamics (UDM). Before surgery, the length of the urethra was calculated with the mpMRI, in the sagittal scan, as the distance from the distal portion of the external urethral sphincter to the bladder neck. During the histological examination, the length of the removed urethra was measured to relate it to the urethral length previously calculated by MRI. RESULTS: The study investigated 190 subjects with a men age of 65.4 y.o. and a mean BMI of 23.8. 3 months after surgery patients were divided into two groups based on the presence (Group B, 96 pts) or absence (Group A, 94pts) of UI evaluated through UDM. At 3 months follow-up a statistically significant difference (p<0.0001) in mean recovery time of UI has been reported (Group A - 12.35 days SD: 3.09 vs Group B 93.86 days SD: 34.8). The ROC curve was statistically significant with an estimated cut-off value of 16.5% (p<0.0001) and a mean sensitivity of 87.5% and specificity of 91.8%. In both groups a statistically significant negative correlation was found between the percentage of spared urethra and the mean recovery time from UI (GroupA: r-0.655; p<0.0001;Group B:r-0.340;p:0.017). Patients of Group A showed an average of 21.52% of spared urethra (SD: 4.34) while group B showed an average value of 13.86% (SD: 2.16; p<0.0001). At one year of follow-up, 177 pts (93.2%), 94 in group A and 83 in group B, reported urinary continence with no need for pads. CONCLUSIONS: Our study highlighted how the percentage of spared urethra after performing RALP correlates with an early recovery of urinary continence. This study is the first that investigated post RALP early continence recovery with UDM. This investigation showed that the amount of urethra saved is one of the surgical variables that may positively correlate with an early recovery of urinary continence after RALP. Source of Funding: Ando S, Kamei J, Yamazaki M, Sugihara T, Kameda T, Fujisaki A, Kurokawa S, Takayama T, Fujimura T. Longer preserved urethral length in robot-assisted radical prostatectomy significantly contributes to post-operative urinary continence recovery. BJUI Compass. 2021 Nov 12;3(2):184-190. doi: 10.1002/bco2.128. PMID: 35474722; PMCID: PMC8988697 © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e854 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Fabio Maria Valenzi More articles by this author Antonio Luigi Pastore More articles by this author Andrea Fuschi More articles by this author Yazan Al Salhi More articles by this author Paolo Pietro Suraci More articles by this author Silvio Scalzo More articles by this author Alice Antonioni More articles by this author Onofrio Antonio Rera More articles by this author Manfredi Bruno Sequi More articles by this author Damiano Graziani More articles by this author Filippo Gianfrancesco More articles by this author Giorgio Martino More articles by this author Giuseppe Candita More articles by this author Alessandro Sciarra More articles by this author Martina Moriconi More articles by this author Cosimo De Nunzio More articles by this author Giorgia Tema More articles by this author Alessandro Zucchi More articles by this author Matteo Pacini More articles by this author Antonio Carbone More articles by this author Expand All Advertisement PDF downloadLoading ...