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Erschienen in: World Journal of Urology 1/2016

01.01.2016 | Original Article

Predictive factors for immediate continence after radical prostatectomy

verfasst von: G. Hatiboglu, D. Teber, D. Tichy, S. Pahernik, B. Hadaschik, J. Nyarangi-Dix, M. Hohenfellner

Erschienen in: World Journal of Urology | Ausgabe 1/2016

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Abstract

Purpose

To identify predictive factors for immediate continence after radical prostatectomy.

Patients and methods

A total of 1553 patients underwent radical prostatectomy in a single institution (670 RRP, 883 RARP), had complete perioperative data and follow-up for urinary continence and were included in this prospective analysis. Immediate continence was defined as no pad usage after catheter removal. Evaluated parameters included age, body mass index, ECOG performance status, erectile function, prostate volume, PSA, Gleason score, tumor stage and D’Amico risk groups, as well as surgical approach (RRP, RARP), surgeon volume, nerve-sparing, lymphadenectomy, blood transfusions and duration of catheterization.

Results

A total of 240 men (15.5 %) did not require any pads 1 day or later after removal of the transurethral catheter. Correlation of parameters with immediate continence revealed significance for age (p < 0.001), ECOG-score (p = 0.025), erectile function (p = 0.001), nerve-sparing (p = 0.022), Gleason score (p = 0.002) and surgeon volume (p ≤ 0.022). Multivariate analyses identified IIEF-score >21 (p = 0.031), ECOG (p < 0.05), bilateral nerve-sparing (p = 0.049), Gleason score <3 + 4 (p ≤ 0.028), less blood transfusion (p ≤ 0.044) and surgeon volume (p ≤ 0.042) as the remaining prognostic parameters for immediate continence after radical prostatectomy. The type of surgical approach (robotic vs. open radical prostatectomy) did not yield significant influence.

Conclusion

Evaluating continence in a contemporary prospective cohort revealed 15.5 % of patients never requiring a pad postoperatively. Predictive parameters for immediate continence were erectile function, ECOG, bilateral nerve-sparing, less blood transfusion and Gleason score. Furthermore, the surgeon’s experience but not his operative technique had a significant impact on immediate postoperative continence.
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Metadaten
Titel
Predictive factors for immediate continence after radical prostatectomy
verfasst von
G. Hatiboglu
D. Teber
D. Tichy
S. Pahernik
B. Hadaschik
J. Nyarangi-Dix
M. Hohenfellner
Publikationsdatum
01.01.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
World Journal of Urology / Ausgabe 1/2016
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-015-1594-4

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