Mp18-12 Preoperative Mri Anatomical Predictors of Early Continence After Single-Port Transvesical Robot-Assisted Radical Prostatectomy

You have accessJournal of UrologyImaging/Uroradiology I (MP18)1 May 2024MP18-12 PREOPERATIVE MRI ANATOMICAL PREDICTORS OF EARLY CONTINENCE AFTER SINGLE-PORT TRANSVESICAL ROBOT-ASSISTED RADICAL PROSTATECTOMY Roxana Ramos, Prasad R. Shankar, Nicolas Soputro, Adriana M. Pedraza, Jaya S. Chavali, Carter Mikesell, Jennifer Bullen, Ryan Ward, Andrei Purysko, and Jihad Kaouk Roxana RamosRoxana Ramos , Prasad R. ShankarPrasad R. Shankar , Nicolas SoputroNicolas Soputro , Adriana M. PedrazaAdriana M. Pedraza , Jaya S. ChavaliJaya S. Chavali , Carter MikesellCarter Mikesell , Jennifer BullenJennifer Bullen , Ryan WardRyan Ward , Andrei PuryskoAndrei Purysko , and Jihad KaoukJihad Kaouk View All Author Informationhttps://doi.org/10.1097/01.JU.0001008672.83391.ed.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Previous studies have associated anatomical factors to continence following radical prostatectomy, with a longer membranous urethral length (MUL) being the most common predictor. Since 2021, one of the reported benefits of single-port (SP) transvesical (TV) robot-assisted radical prostatectomy (RARP) has been a short time to continence, with a median of 3 to 7 days. Our objective is to identify preoperative anatomical predictors associated with an early return to continence after SP TV RARP. METHODS: Retrospective single-center cohort study of SP TV RARP cases from January 2022 to March 2023 with preoperative multiparametric magnetic resonance imaging (MP-MRI). Two urogenital radiologists independently reviewed the images and assessed 10 anatomical parameters (Figure 1) to determine their ability to distinguish men who achieved urinary continence within 1 week and 3 months of SP TV RARP from those who did not. For each MRI parameter and clinical outcome, we used nonparametric methods to estimate the receiver operating characteristic (ROC) curve and its area (AUC) for each reader. Intraclass correlation coefficient (ICC) was used to quantify inter-reader agreement. All analyses were performed in R version 4.3.0. RESULTS: A total of 44 cases were reviewed. Fifteen men (34%) achieved urinary continence within one week, while 29 (67%) achieved continence within 3 months. In this interim analysis, MUL was the only parameter that showed a significant association with early return to continence (Figure 2). The AUC for coronal MUL at the one-week time point was 0.68 (95% CI: 0.53, 0.83). Inter-reader agreement was moderate for all measured variables (ICC range 0.42-0.82). CONCLUSIONS: In this interim analysis, MUL was the only preoperative anatomical factor significantly associated with continence within a week and three months after SP TV RARP. Postoperative MRI comparison studies are needed to assess the uniqueness of the SP TV RARP technique in sparing periprostatic structures to facilitate an early return to continence. Download PPTDownload PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e305 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Roxana Ramos More articles by this author Prasad R. Shankar More articles by this author Nicolas Soputro More articles by this author Adriana M. Pedraza More articles by this author Jaya S. Chavali More articles by this author Carter Mikesell More articles by this author Jennifer Bullen More articles by this author Ryan Ward More articles by this author Andrei Purysko More articles by this author Jihad Kaouk More articles by this author Expand All Advertisement PDF downloadLoading ...