Use of preoperative factors including urodynamic evaluations and nerve-sparing status for predicting urinary continence recovery after robot-assisted radical prostatectomy: Nerve-sparing technique contributes to the reduction of postprostatectomy incontinence

作者：Kadono Yoshifumi^*; Ueno Satoru; Kadomoto Suguru; Iwamoto Hiroaki; Takezawa Yuta; Nakashima Kazufumi; Nohara Takahiro; Izumi Kouji; Mizokami Atsushi; Gabata Toshifumi; Namiki Mikio

来源：Neurourology and Urodynamics, 2016, 35(8): 1034-1039.

DOI：10.1002/nau.22877

• nerve sparing
• prostatectomy
• urodynamic
• urinary incontinence

AimsTo examine which preoperative factors, including urodynamic evaluations, and operative procedures could predict continence status after robot-assisted radical prostatectomy (RARP) in this study.
Materials and MethodsUnivariate and multivariate logistic regression analyses of preoperative factors such as age, body mass index, prostate-specific antigen level before biopsy, prostate size before surgery, membranous urethral length measured using magnetic resonance imaging (MRI), bladder compliance and maximum urethral closure pressure (MUCP) measured by urodynamic study (UDS), and nerve-sparing (NS) status predicting 24-hr pad test >2g/day at 1 year after RARP were examined in 111 patients enrolled in this study.
ResultsThe number of patients with incontinence at 1 year after RARP was 39 (35.1%). The only predictive factor for urinary continence was NS grades. To investigate the contribution of NS to urinary continence, 84 patients underwent UDS three times; before, immediately after, and 1 year after RARP. Chronological UDS revealed that recovery patterns of storage and voiding functions were the same among non-NS, unilateral-NS, and bilateral-NS groups, and that higher degrees of NS contributed to lesser decreases in MUCP and longer functional urethral length (FUL) after RARP.
ConclusionPreoperative factors, including the results of UDS, could not predict continence 1 year after RARP. The NS procedure contributed to continence status. NS favorably affected MUCP and FUL; however, it did not affect bladder function after RARP. Neurourol. Urodynam. 35:1034-1039, 2016.

• 出版日期2016-11