Intravesical prostatic protrusion may affect early postoperative continence undergoing robot-assisted radical...

Area of Science:

• Urology
• Surgical Oncology
• Reconstructive Urology

Background:

• Robot-assisted radical prostatectomy (RARP) is a common treatment for prostate cancer.
• Postoperative urinary incontinence (UI) remains a significant concern for patients undergoing RARP.
• Preoperative prostate morphology, particularly intravesical prostatic protrusion (IPP), may influence UI outcomes.

Purpose of the Study:

• To investigate the association between preoperative intravesical prostatic protrusion (IPP) and continence after RARP.
• To evaluate the impact of IPP and nerve-sparing (NS) techniques on early and late UI following RARP.

Main Methods:

• Retrospective analysis of 119 patients who underwent RARP.
• Assessment of preoperative factors including IPP, age, BMI, PSA, MRI, and pressure-flow studies.
• Multivariate logistic regression analysis to determine predictors of UI; patients grouped by IPP length (<5 mm vs. ≥5 mm).

Main Results:

• IPP and nerve-sparing (NS) were significant factors for UI in the first month post-RARP.
• At 12 months, only NS remained a significant factor for UI.
• Patients with smaller IPP (<5 mm) showed higher early continence rates, but this difference resolved by 3 months.

Conclusions:

• Intravesical prostatic protrusion (IPP) is associated with early postoperative urinary incontinence (UI) after RARP.
• Nerve-sparing (NS) techniques are critical for achieving continence in both early and late stages post-RARP.
• The impact of IPP on UI appears to be transient, with no significant effect in later stages.