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Factors Affecting Return of Continence 3 Months After Robot-Assisted Radical Prostatectomy: Analysis From a Large, Prospective Data by a Single Surgeon.
MedLine Citation:
PMID:  22114811     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: In this study we identified preoperative or intraoperative factors responsible for the early return of continence after robot-assisted radical prostatectomy using data from a high volume center. MATERIALS AND METHODS: Data from 1,299 patients who underwent robot-assisted radical prostatectomy performed by a single surgeon from January 2008 to June 2010 were collected prospectively and analyzed retrospectively. Patients were categorized according to whether they regained continence (no pad and no urinary leakage) within 3 months and variables were then compared. A self-administered validated questionnaire (Expanded Prostate Cancer Index Composite) was used for assessment of continence status and time to recovery. RESULTS: Within 3 months after surgery 86.3% of patients (1,121/1,299) had recovered continence. Multivariable Cox regression analysis revealed that only age (p <0.001, hazard ratio 0.98, 95% CI 0.97-0.99) and performance of a nerve sparing procedure were independent predictors. After adjusting for age, the hazard ratio was 1.61 (95% CI 1.25-2.07, p <0.001) for partial nerve sparing and 1.44 (1.13-1.83, p = 0.003) for bilateral nerve sparing compared to the nonnerve sparing group. Median time (95% CI) to the recovery of continence was prolonged in the nonnerve sparing group compared to nerve sparing counterparts at 6 (5.12-6.88), 4 (3.60-4.40) and 5 weeks (4.70-5.30) in the nonnerve sparing, partial nerve sparing and bilateral nerve sparing groups, respectively, with log rank p <0.01. CONCLUSIONS: Findings from our analysis indicate that the likelihood of postoperative urinary control was significantly higher in younger patients and when a nerve sparing procedure was performed.
Authors:
Young Hwii Ko; Rafael F Coelho; Sanket Chauhan; Ananthakrishnan Sivaraman; Oscar Schatloff; Jun Cheon; Vipul R Patel
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-22
Journal Detail:
Title:  The Journal of urology     Volume:  -     ISSN:  1527-3792     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Affiliation:
Global Robotics Institute, Florida Hospital Celebration Health, Celebration, and University of Central Florida School of Medicine, Orlando, Florida; Department of Urology, Korea University School of Medicine, Seoul, Korea.
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