AB012. SOH24AB_018. Membranous urethral length and urinary incontinence post robot assisted radical prostatectomy?—A systematic review and meta-analysis

Background: To provide an update on the association between preoperative membranous urethral length (MUL) and postoperative urinary incontinence (UI) in men who undergo robot assisted radical prostatectomy (RARP)/robot assisted laparoscopic prostatectomy (RALP). Methods: A systematic review was carried out according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, using PubMed, Embase, and Scopus databases. Inclusion criteria were English language full journal articles from the last five years that assessed continence using the Expanded Prostate Cancer Index Composite (EPIC). The Critical Appraisal Skills Programme (CASP) tool for retrospective cohort studies was used to evaluate study quality. A random-effects meta-analysis was performed to pool odds ratios from available studies relating to continence as a function of MUL. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework was used to synthesise evidence. Results: Six studies including 970 patients reported an association between MUL and continence at 12 months. Longer MUL was associated with reduced incontinence odds at 12-months post-surgery [pooled odds ratio (OR): 0.74, 95% confidence interval (CI): 0.68–0.87, P<0.001]. Conclusions: Preoperative MUL measured on MRI is significantly associated with postoperative continence in men undergoing RARP/RALP. We recommend consideration of magnetic resonance imaging (MRI) measurement of MUL prior to RARP/RALP to guide treatment decisions in this population.