Predictors of prolonged severe urinary incontinence after robot-assisted radical prostatectomy: a prospective study

• Published in: FUKUSHIMA JOURNAL OF MEDICAL SCIENCE p. 24-00031
• Main Authors: Tanji, Ryo, Haga, Nobuhiro, Hiraguri, Akari, Tsumori, Takahiro, Kumekawa, Tomoyuki, Yoshioka, Shunsuke, Natsuya, Hiroki, Kirihana, Yusuke, Hakozaki, Yusuke, Endo, Yu, Yaginuma, Kei, Makabe, Syunta, Hasegawa, Akihisa, Harigane, Yuki, Imai, Hitomi, Meguro, Satoru, Onagi, Akifumi, Takinami, Ruriko, Matsuoka, Kanako, Hoshi, Seiji, Kayama, Emina, Koguchi, Tomoyuki, Hata, Junya, Sato, Yuichi, Akaihata, Hidenori, Kataoka, Masao, Ogawa, Soichiro, Kojima, Yoshiyuki
• Format: Journal Article
• Language: English
• Published: Japan THE FUKUSHIMA SOCIETY OF MEDICAL SCIENCE 2025
• Subjects: high-risk localized prostate cancer; obesity; RARP; urinary incontinence; high-risk localized prostate cancer; RARP; urinary incontinence; obesity
• ISSN: 0016-2590; 2185-4610
• DOI: 10.5387/fms.24-00031

Objectives:To identify predictors of prolonged severe urinary incontinence after robot-assisted radical prostatectomy (RARP), perioperative clinical parameters were investigated.Methods:Participants were 299 patients who underwent RARP at our institute.　Prolonged severe urinary incontinence was defined as a 1-h (one-hour) pad test >50 g/h and/or use of >3 pads/day at 12 months after RARP.　The cohort was divided into severe and non-severe urinary incontinence groups according to this criterion.　Perioperative clinical parameters were compared between groups to identify predictors for prolonged severe urinary incontinence after RARP.Results:Twenty-seven patients (9.0%) were categorized into the severe urinary incontinence group.　The remaining 272 patients (91.0%) were categorized into the non-severe urinary incontinence group.　Univariate analysis revealed prolonged severe urinary incontinence as significantly associated with older age (P=0.011), high BMI (P=0.001), lymph node dissection (P=0.003), non-preservation of nerves (P=0.039), non-preservation of fascia of the levator ani muscle (P=0.009), and high risk in the D’Amico risk classification (P=0.010).　Multivariate analysis revealed prolonged severe urinary incontinence as significantly correlated with high BMI (P=0.009) and high risk in the D’Amico risk classification (P=0.007).Conclusions:High BMI and D’Amico high-risk status are associated with prolonged severe urinary incontinence after RARP.