Presented by: Andrey Shvedov
Federal State Budgetary Educational Institution of the Higher Education “A.I. Yevdokimov Moscow State University of Medicine and Dentistry” of the Ministry of Healthcare of the Russian Federation

Introduction

Radical prostatectomy is the gold standard localized prostate cancer treatment. Continued  innovation of the robot-assisted radical prostatectomy (RARP) since 2001 has resulted in an effective,  high quality surgical treatment for prostate cancer. Complete recovery of urinary continence, however,  remain challenging to achieve. It is crucial to assess the risks of incontinence preoperatively and, if  necessary, choose a different treatment method

Materials

We conducted a prospective cohort study that included 127 patients who  underwent radical robot-assisted prostatectomy. Several risk factors for urinary incontinence were  found. Then using logistic regression an online nomogram of the probability of urinary incontinence was  created

Results

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In the early postoperative period, urinary incontinence occurred in 88 (70.3%) patients, but by  the 12th month of follow-up, this number had decreased to 14 (11%). Seventy (79,5%) patients noted a  significant decrease in the quality of life after surgery. Age, body mass index, length of the membranous  urethra, size of m. levator ani, a history of prostate surgery and symptoms of an overactive bladder were  urinary incontinence predictors. Using the logistic regression method, the data obtained in a specific  time interval was analyzed, after which the logistic regression equation was constructed. Then, based on  these equations, an online nomogram was created to calculate the probability of urinary incontinence  on the 7th day and 1,3,6,12 months after removal of the urethral catheter. Urologists can use this  nomogram on regular base

Conclusion

Despite the development of surgical techniques and understanding of the anatomy urinary  incontinence after robot-assisted prostatectomy is a frequent functional complication. The negative  impact of urinary incontinence on the quality of life is obvious. Searching of risk factors and the ability to  calculate the probability of urinary incontinence will help to choose the optimal method of treatment.

Funding

The study was not sponsored

Lead Authors

Dmitrii Pushkar, MD
Federal State Budgetary Educational Institution of the Higher Education “A.I. Yevdokimov Moscow State University of Medicine and Dentistry” of the Ministry of Healthcare of the Russian Federation

Co-Authors

Konstantin Kolontarev, MD
Federal State Budgetary Educational Institution of the Higher Education “A.I. Yevdokimov Moscow State University of Medicine and Dentistry” of the Ministry of Healthcare of the Russian Federation

Alexander Govorov, MD
Federal State Budgetary Educational Institution of the Higher Education “A.I. Yevdokimov Moscow State University of Medicine and Dentistry” of the Ministry of Healthcare of the Russian Federation