Ozawa Yu, Koike Shin, Aoki Keisuke, Okamoto Keita, Ushijima Kei, Kayaba Toshiaki, Nohara Sunao, Yamada Masumi, Odagaki Yu, Sakamoto Hideo, Yoshioka Kunihiko
Department of Urology, Itabashi Chuo Medical Center, 2-12-7 Azusawa, Itabashi, Tokyo, 174-0051, Japan.
Int J Clin Oncol. 2025 Jan;30(1):134-143. doi: 10.1007/s10147-024-02653-6. Epub 2024 Nov 6.
To assess the predictive factors of immediate urinary continence after robot-assisted radical prostatectomy.
This study included 282 patients who underwent conventional robot-assisted radical prostatectomy at our institution from April 2019 to March 2024. The primary outcome was immediate urinary continence, defined as the absence of urine leakage immediately after urinary catheter removal on postoperative day 6 or 7. In addition, the immediate urine loss rate, defined as the 24-h urine loss volume divided by the total urine volume after catheter removal, was calculated. The multivariable logistic model was used to assess the possible predictive factors of immediate continence (urine loss rate of 0%). The factors included age, body mass index, Charlson Comorbidity Index, pre-existing lower urinary tract symptoms, presence of an inguinal hernia, prostate volume, membranous urethral length, stratified cancer risk, surgeon's experience, and nerve-sparing procedure. In addition, a multiple linear regression model was established to investigate the associations of the same predictors with immediate urine loss rate (%). We also presented our techniques to achieve immediate continence.
The patients' median age was 70 (interquartile range: 63.0-73.0) years. Approximately 39% (n = 111) of patients presented with immediate continence. Age, inguinal hernia, membranous urethral length, and low risk for prostate cancer were associated with immediate continence. These were also statistically significant predictors of immediate urine loss rate.
Our study identified factors predicting immediate urinary continence after conventional robot-assisted radical prostatectomy. This information is potentially valuable for preoperative counseling in patients undergoing robot-assisted radical prostatectomy.
评估机器人辅助根治性前列腺切除术后即刻尿控的预测因素。
本研究纳入了2019年4月至2024年3月在我院接受传统机器人辅助根治性前列腺切除术的282例患者。主要结局为即刻尿控，定义为术后第6或7天拔除尿管后立即无尿漏。此外，计算即刻尿失禁率，定义为拔除尿管后24小时尿量除以总尿量。采用多变量逻辑模型评估即刻尿控（尿失禁率为0%）的可能预测因素。这些因素包括年龄、体重指数、Charlson合并症指数、既往下尿路症状、腹股沟疝的存在、前列腺体积、膜性尿道长度、分层癌症风险、外科医生经验和保留神经手术。此外，建立多元线性回归模型以研究相同预测因素与即刻尿失禁率（%）的关联。我们还介绍了实现即刻尿控的技术。
患者的中位年龄为70岁（四分位间距：63.0 - 73.0）。约39%（n = 111）的患者实现了即刻尿控。年龄、腹股沟疝、膜性尿道长度和前列腺癌低风险与即刻尿控相关。这些也是即刻尿失禁率的统计学显著预测因素。
我们的研究确定了传统机器人辅助根治性前列腺切除术后即刻尿控的预测因素。这些信息对于接受机器人辅助根治性前列腺切除术的患者进行术前咨询可能具有重要价值。
