Mp52-11 Extended Preservation of the Prostatic Urethra Mitigates the Disadvantage of Innate Short Membranous Urethral Length

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy II (MP52)1 May 2024MP52-11 EXTENDED PRESERVATION OF THE PROSTATIC URETHRA MITIGATES THE DISADVANTAGE OF INNATE SHORT MEMBRANOUS URETHRAL LENGTH Narmina Khanmammadova, Andrei D. Cumpanas, Daniel Jiang, Andrew Shea Afyouni, Mitchell O'Leary, Timothy Chu, Ashley Gao, Jacob Tsai, Tuan Thanh Nguyen, Sohrab Naushad Ali, Mohammed Shahait, and David I. Lee Narmina KhanmammadovaNarmina Khanmammadova , Andrei D. CumpanasAndrei D. Cumpanas , Daniel JiangDaniel Jiang , Andrew Shea AfyouniAndrew Shea Afyouni , Mitchell O'LearyMitchell O'Leary , Timothy ChuTimothy Chu , Ashley GaoAshley Gao , Jacob TsaiJacob Tsai , Tuan Thanh NguyenTuan Thanh Nguyen , Sohrab Naushad AliSohrab Naushad Ali , Mohammed ShahaitMohammed Shahait , and David I. LeeDavid I. Lee View All Author Informationhttps://doi.org/10.1097/01.JU.0001008864.84854.b7.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Short preoperative membranous urethral length (MUL) (<1.2 cm) has been shown to have a significant negative impact on continence recovery following the robot-assisted radical prostatectomy (RARP). Meticulous prostatic apex dissection and extended preservation of the prostatic urethra have been hypothesized to improve early continence recovery outcomes. Thereby, we sought to assess whether extended preservation of the prostatic urethra during apical dissection might mitigate the disadvantages of innate short MUL. METHODS: 248 patients underwent RARP from May 2021 to July 2023 and 155 (63%) patients had MUL measurement available. Short MUL was defined as MUL <1.2cm measured on T2-weighted MRI. We compared 3-month continence outcomes between the patients with innate short MUL (n=22) and patients with normal MUL (n=133). All patients underwent extended preservation of the prostatic urethra by 360-degree dissection of the apex before transection of the urethra. Continence was defined as using 0-1 security pads per day. Two-tailed Fisher's Exact test was utilized to assess the difference between continence rates of the two groups. Additionally, correlation between MUL and the likelihood of a patient being continent at 3-months postoperatively was assessed by a binary logistic regression. RESULTS: Patient characteristics are demonstrated in Table 1. Baseline patient and tumor characteristics were comparable between all groups. In our cohort, overall patient-reported continence rate at post-op 3-months was 75% (n=185/237).No difference was observed in postoperative 3-month urinary continence rates between patients with innate short MUL (67%) and normal MUL (80%, p=0.252). Moreover, considering MUL as either a continuous (OR:0.38; 95% CI: 0.13 – 1.1; p=0.075) or categorical variable (MUL <1.2 cm, MUL ≥1.2cm) did not correlate with the likelihood of a patient-reported continence at 3-months postoperatively (OR:0.5; 95% CI: 0.18 – 1.37; p=0.176). CONCLUSIONS: The modified 360-degree apex dissection for extended preservation of the prostatic urethra mitigates the disadvantages of innate short MUL on early continence recovery following RARP. Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e856 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Narmina Khanmammadova More articles by this author Andrei D. Cumpanas More articles by this author Daniel Jiang More articles by this author Andrew Shea Afyouni More articles by this author Mitchell O'Leary More articles by this author Timothy Chu More articles by this author Ashley Gao More articles by this author Jacob Tsai More articles by this author Tuan Thanh Nguyen More articles by this author Sohrab Naushad Ali More articles by this author Mohammed Shahait More articles by this author David I. Lee More articles by this author Expand All Advertisement PDF downloadLoading ...