Association between 3D membranous urethral parameters and urinary continence recovery after RARP

Area of Science:

• Urology
• Oncology
• Radiology

Background:

• Robotic-assisted radical prostatectomy (RARP) is a common treatment for prostate cancer.
• Urinary continence (UC) recovery post-RARP is a significant concern for patients.
• The anatomical factors influencing UC recovery are not fully understood.

Purpose of the Study:

• To investigate the relationship between membranous urethral length (MUL) and membranous urethral complex volume (MUV) and UC recovery after RARP.
• To identify predictors of early and sustained urinary continence following RARP.

Main Methods:

• A cohort of 120 patients undergoing RARP was analyzed.
• Preoperative prostate magnetic resonance imaging (MRI) was used to measure MUL and MUV parameters.
• Three-dimensional (3D) models and holographic technology were employed for precise measurements of total MUV (tMUV), exposed MUV (eMUV), full MUL (fMUL), and exposed MUL (eMUL).

Main Results:

• Larger tMUV, eMUV, fMUL, and eMUL were associated with better UC after catheter removal.
• Exposed MUV (eMUV) emerged as a significant predictor of UC recovery at different time points.
• Younger age, lower VPSS score, larger eMUV, and longer eMUL were associated with better UC recovery at one and three months post-RARP.

Conclusions:

• Preoperative measurements of MUV and MUL are valuable in predicting UC recovery after RARP.
• Increased membranous urethral volume and length correlate with earlier return to urinary continence.
• Exposed MUV is identified as a particularly strong predictor of successful urinary continence outcomes.