Continence recovery time after radical prostatectomy: implication of prostatic apical tumor

Despite the role of prostatic apex on post-radical prostatectomy incontinence (PPI) has been encountered, the impact of prostatic apex tumor on urinary recovery has been poorly adressed. We aimed to evaluate the effect of prostatic apex tumor on PPI.

Between January 2008 and December 2011, a total 36 consecutive patients who underwent open retropubic radical prostatectomy (RRP) for prostate adenocancer (PCa) were analyzed. The patients were divided into two groups according to the presence of prostatic apical tumor. Urinary incontinence was assessed at regular intervals following RP using validated Incontinence Questionnaire-Short Form and 24-hour pad use based on patients' reports. Urinary continence was defined as wearing no pads. All patients' functional and oncological data were recorded.

Overall urinary continence rate at one year was 90%. There was a statistical difference between two groups in terms of urinary recovery (P=0.024). The 1 week, 1 month, 3 month, 6 months and 1 year postoperative continence rates were 28%, 50%, 85%, 92.9% and 92.9%, respectively, in patients with apex infiltration (-) group, compared with 0%, 22.7%, 45.5%, 72.7% and 86.4%, respectively, in patients with infiltration (+) group.

The results provided that infiltration of the prostatic apex could significantly affect urinary continence recovery time after RP and advanced pathologic stage could be a risk for PPI.