OBJECTIVES: In this long-term prospective study we evaluated the factors affecting urinary continence after radical prostatectomy. METHODS: In this study, we recruited 156 patients (mean age, 64.1 +/- 6.7 years; follow-up, 7.8 +/- 1.3 years; prostate-specific antigen [PSA] level, 9.57 +/- 8.81 ng/mL) who underwent radical prostatectomy between 1995 and 1998. Long-term data were obtained on 152 patients, with 4 patients lost to follow-up. Incontinence was evaluated by the number of pads per day. Follow-up data were collected at 3, 6, 12, and 24 months and annually. The multivariate analysis included the following variables: preoperative PSA levels, nerve-sparing (NS) status (bilateral NS, unilateral NS, and non-NS), and age at the time of operation (< or = 65 or > 65 years). RESULTS: With a mean follow-up of 7.8 +/- 1.3 years, the overall incontinence rate was 17.7% (27 of 152). The incontinence rates were significantly higher in the non-NS group (18 of 61) compared with the bilateral NS group (6 of 66; P <0.05). No significant difference was seen between the unilateral NS and non-NS groups in terms of incontinence rates (P >0.05). When stratified by the NS status, the bilateral NS group had a significant improvement in overall continence. The association between age and incontinence was significant: P <0.05 for patients 65 years or younger (7 of 85) versus those older than 65 years (20 of 67). The association between the preoperative PSA levels and incontinence was not significant but showed a trend (the median PSA in the incontinence group was 8.75 ng/mL; in the continence group it was 5.9 ng/mL; P = 0.0534). CONCLUSIONS: Nerve-sparing radical prostatectomy improves the time interval to regain continence and long-term continence rates.
OBJECTIVES: In this long-term prospective study we evaluated the factors affecting urinary continence after radical prostatectomy. METHODS: In this study, we recruited 156 patients (mean age, 64.1 +/- 6.7 years; follow-up, 7.8 +/- 1.3 years; prostate-specific antigen [PSA] level, 9.57 +/- 8.81 ng/mL) who underwent radical prostatectomy between 1995 and 1998. Long-term data were obtained on 152 patients, with 4 patients lost to follow-up. Incontinence was evaluated by the number of pads per day. Follow-up data were collected at 3, 6, 12, and 24 months and annually. The multivariate analysis included the following variables: preoperative PSA levels, nerve-sparing (NS) status (bilateral NS, unilateral NS, and non-NS), and age at the time of operation (< or = 65 or > 65 years). RESULTS: With a mean follow-up of 7.8 +/- 1.3 years, the overall incontinence rate was 17.7% (27 of 152). The incontinence rates were significantly higher in the non-NS group (18 of 61) compared with the bilateral NS group (6 of 66; P <0.05). No significant difference was seen between the unilateral NS and non-NS groups in terms of incontinence rates (P >0.05). When stratified by the NS status, the bilateral NS group had a significant improvement in overall continence. The association between age and incontinence was significant: P <0.05 for patients 65 years or younger (7 of 85) versus those older than 65 years (20 of 67). The association between the preoperative PSA levels and incontinence was not significant but showed a trend (the median PSA in the incontinence group was 8.75 ng/mL; in the continence group it was 5.9 ng/mL; P = 0.0534). CONCLUSIONS: Nerve-sparing radical prostatectomy improves the time interval to regain continence and long-term continence rates.
Authors: Justin K Lee; Melissa Assel; Alan E Thong; Daniel D Sjoberg; John P Mulhall; Jaspreet Sandhu; Andrew J Vickers; Behfar Ehdaie Journal: Eur Urol Date: 2015-08-17 Impact factor: 20.096
Authors: Paul Toren; Shabbir M H Alibhai; Andre Matthew; Michael Nesbitt; Robin Kalnin; Neil Fleshner; John Trachtenberg Journal: Can Urol Assoc J Date: 2009-12 Impact factor: 1.862