Urinary continence after radical prostatectomy: Predictive factors of recovery after 1 year of surgery

Objectives:  To evaluate the clinical prognosis of incontinence and to determine the predictors for further recovery of urinary continence in patients not achieving urinary continence within 1 year after radical prostatectomy. Methods:  A total of 708 patients were evaluated regarding urinary contin...

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Veröffentlicht in:International journal of urology 2012-12, Vol.19 (12), p.1091-1098
Hauptverfasser: Jeong, Seong Jin, Kim, Hyeon June, Kim, Jeong Hyun, Oh, Jong Jin, Lee, Sang Cheol, Jeong, Chang Wook, Yoon, Cheol Yong, Hong, Sung Kyu, Byun, Seok-Soo, Lee, Sang Eun
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Sprache:eng
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Zusammenfassung:Objectives:  To evaluate the clinical prognosis of incontinence and to determine the predictors for further recovery of urinary continence in patients not achieving urinary continence within 1 year after radical prostatectomy. Methods:  A total of 708 patients were evaluated regarding urinary continence status at 1 year after surgery from a prospectively maintained radical prostatectomy database. Of these, 73 (10.3%) did not recover urinary continence within 1 year after surgery. For these patients, incontinence status and the number of pads for urinary control were assessed serially. Results:  In 708 patients, factors associated with the recovery of urinary continence within 1 year after radical prostatectomy were membranous urethral length, prostatic apex shape and patient age. Among 73 patients with urinary incontinence, 41 (56.2%) achieved urinary continence with a mean time of 15.4 months subsequent to the first year after radical prostatectomy (baseline). A younger age at surgery (P = 0.027) and one pad being required (vs≥2 pads) at baseline (P = 0.046) were identified as independent factors for achievement of urinary continence within a further 2 years. Only the number of pads was a significant factor for further recovery of urinary continence in the longer follow up (hazard ratio 0.36, P = 0.029). Conclusion:  Compared with factors related to the prostate or membranous urethra, patient age and severity of incontinence at 1 year after radical prostatectomy are more strongly related to the recovery of urinary continence later than 1 year after surgery. These findings might help to decide whether a definite treatment is required for persistent incontinence beyond 1 year after radical prostatectomy.
ISSN:0919-8172
1442-2042
DOI:10.1111/j.1442-2042.2012.03106.x