Urinary Continence after Robot-Assisted Laparoscopic Radical Prostatectomy: The Impact of Intravesical Prostatic Protrusionopen access
- Authors
- Jo, Jung Ki; Hong, Sung Kyu; Byun, Seok-Soo; Zargar, Homayoun; Autorino, Riccardo; Lee, Sang Eun
- Issue Date
- Sep-2016
- Publisher
- YONSEI UNIV COLL MEDICINE
- Keywords
- Continence; intravesical prostatic protrusion; robot assisted radical prostatectomy; transrectal ultrasonography
- Citation
- YONSEI MEDICAL JOURNAL, v.57, no.5, pp.1145 - 1151
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- YONSEI MEDICAL JOURNAL
- Volume
- 57
- Number
- 5
- Start Page
- 1145
- End Page
- 1151
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/154002
- DOI
- 10.3349/ymj.2016.57.5.1145
- ISSN
- 0513-5796
- Abstract
- Purpose: To assess the impact of intravesical prostatic protrusion (IPP) on the outcomes of robot-assisted laparoscopic prostatectomy (RALP). Materials and Methods: The medical records of 1094 men who underwent RALP from January 2007 to March 2013 were analyzed using our database to identify 641 additional men without IPP (non-IPP group). We excluded 259 patients who presented insufficient data and 14 patients who did not have an MRI image. We compared the following parameters: preoperative transrectal ultrasound, prostate specific antigen (PSA), clinicopathologic characteristics, intraoperative characteristics, postoperative oncologic characteristics, minor and major postoperative complications, and continence until postoperative 1 year. IPP grade was stratified by grade into three groups: Grade 1 (IPP <= 5 mm), Grade 2 (5 mm< IPP <= 10 mm), and Grade 3 (IPP> 10 mm). Results: Of the 821 patients who underwent RALP, 557 (67.8%) experienced continence at postoperative 3 months, 681 (82.9%) at 6 months, and 757 (92.2%) at 12 months. According to IPP grade, there were significant differences in recovering full continence at postoperative 3 months, 6 months, and 12 months (p<0.001). On multivariate analysis, IPP was the most powerful predictor of postoperative continence in patients who underwent RALP (p<0.001). Using a generalized estimating equation model, IPP also was shown to be the most powerful independent variable for postoperative continence in patients who underwent RALP (p<0.001). Conclusion: Patients with low-grade IPP have significantly higher chances of recovering full continence. Therefore, the known IPP grade will be helpful during consultations with patients before RALP.
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