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Related Experiment Video

Updated: May 22, 2026

Retzius-Sparing Robot-Assisted Radical Prostatectomy
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Retzius-Sparing Robot-Assisted Radical Prostatectomy

Published on: May 19, 2022

CT-Measured Psoas Area Predicts Urinary Incontinence Trajectories and Persistence After Robotic Prostatectomy: A

Akihisa Hasegawa1, Kenji Omae2, Yuki Harigane1

  • 1Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan.

Clinical Genitourinary Cancer
|May 20, 2026
PubMed
Summary

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Preoperative psoas major muscle cross-sectional area (PMM-CSA) predicts urinary incontinence (UI) after prostatectomy. Lower PMM-CSA is linked to persistent moderate-to-severe UI and slower recovery, aiding risk assessment.

Area of Science:

  • Urology
  • Surgical Oncology
  • Radiology

Background:

  • Urinary incontinence (UI) is a common complication following robot-assisted radical prostatectomy (RARP).
  • Predictive markers for persistent UI post-RARP are needed, as existing sarcopenia-related evidence is inconsistent.
  • Preoperative psoas major muscle cross-sectional area (PMM-CSA) is a potential objective marker for UI prediction.

Purpose of the Study:

  • To assess the predictive value of preoperative PMM-CSA for moderate-to-severe UI at 12 months post-RARP.
  • To investigate the association between preoperative PMM-CSA and longitudinal continence recovery after RARP.

Main Methods:

  • A cohort study of 449 patients undergoing RARP.
  • Preoperative CT scans measured PMM-CSA at the L3 vertebral level.
Keywords:
ComplicationProstate cancerPsoas major muscleRobot-assisted radical prostatectomySarcopenia

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  • UI volume assessed via 1-hour pad test (1hPT) at multiple postoperative time points; moderate-to-severe UI defined as ≥11 g.

    • Main Results:

    • Moderate-to-severe UI at 12 months was observed in 14.3% of patients.
    • Preoperative PMM-CSA significantly predicted moderate-to-severe UI (OR per 1 cm² increase: 0.86; 95% CI: 0.79-0.92).
    • Reduced PMM-CSA correlated with increased UI volume from 3 to 12 months postoperatively.

    Conclusions:

    • Preoperative PMM-CSA is a significant predictor of moderate-to-severe UI 12 months after RARP.
    • PMM-CSA is associated with the pattern of longitudinal continence recovery.
    • Preoperative PMM-CSA assessment can aid in risk stratification, patient counseling, and preventive strategies for UI post-RARP.