Document Detail


Predictors of immediate continence following robot-assisted radical prostatectomy.
MedLine Citation:
PMID:  23030798     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Few studies have examined the patient characteristics that lead to early continence after robot-assisted radical prostatectomy (RARP), and to date, there has been no investigation into the predictors of immediate continence. In the current study, we examine a large multisurgeon population of patients undergoing RARP to assess for predictors of this outcome.
PATIENTS AND METHODS: Between January 2008 and December 2010, 1270 patients who underwent RARP at our institution, with complete preoperative and follow-up data, were assessed for urinary function prospectively. Univariable and multivariable logistic regressions were used to assess for predictors of zero pad usage after RARP. Patient and operative characteristics examined include age, body-mass index, prostate-specific antigen, adjusted Charlson comorbidity index (CCI), Gleason sum, international prostate symptom score, clinical stage, nerve sparing, bladder neck reconstruction, posterior anastomotic reconstruction, surgeon volume, and percutaneous suprapubic tube (PST) bladder drainage.
RESULTS: Overall, 17.3% of patients (n=219) never required a pad after catheter removal. Characteristics associated with never requiring a pad are age, preoperative Gleason sum, CCI, nerve sparing, prostate weight, surgeon volume, and PST bladder drainage. Independent predictors of never requiring a pad after catheter removal included nerve-sparing (B/L standard as referent) wide dissection [OR: 0.96 (95% CI: 0.49, 1.88)], unilateral inter-/intrafascial [OR: 1.20 (0.70, 2.06)], bilateral inter-/intrafascial [OR: 1.97 (1.36, 2.86)], and PST drainage [OR: 2.53 (1.56, 4.11)].
CONCLUSION: In a study reflective of broad RARP practice at our institution, 17.3% of patients were entirely pad free after RARP. The type of nerve sparing performed and placement of a PST for bladder drainage postoperatively were found to be independently predictive of never requiring a pad after RARP.
Authors:
Jesse D Sammon; Pranav Sharma; Quoc-Dien Trinh; Khurshid R Ghani; Shyam Sukumar; Mani Menon
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2012-12-05
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  27     ISSN:  1557-900X     ISO Abbreviation:  J. Endourol.     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-04-09     Completed Date:  2013-09-25     Revised Date:  2013-10-24    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  442-6     Citation Subset:  IM    
Affiliation:
Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI 48202, USA. jsammon79@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Demography
Humans
Male
Middle Aged
Multivariate Analysis
Prostatectomy / adverse effects*
Robotics*
Urinary Incontinence / etiology*
Comments/Corrections
Comment In:
J Endourol. 2013 Sep;27(9):1172   [PMID:  23631752 ]
J Endourol. 2013 Sep;27(9):1172-3   [PMID:  23931667 ]
J Urol. 2013 Oct;190(4):1249-50   [PMID:  24029316 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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