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Prevalence analysis of urinary incontinence after radical prostatectomy and influential preoperative factors in a single institution
Authors:Antonio Tienza  Jose E Robles  Mateo Hevia  Ruben Algarra  Fernando Diez-Caballero  Juan I Pascual
Institution:Department of Urology, Clinica Universidad de Navarra, Pamplona, Spain
Abstract:Aims: To assess prevalence of urinary incontinence (UI) after radical prostatectomy (RP) and to analyze which preoperative characteristics of the patients have influence on UI.

Methods: Between 2002 and 2012, 746 consecutive patients underwent RP for clinically localized prostate cancer. We defined UI according to International Continence Society (ICS) definition: “the complaint of any involuntary leakage of urine” after 12?months of recovery, international consultation on incontinence questionnaire (ICIQ-SF) and pads/day was collected too. Clinical features and magnetic resonance imaging measurements were assessed. A multivariable logistic regression model predicting incontinence were built-in after adjust by cofounding factors and bootstrapping.

Results: About 172 (23%) of the patients were classified as incontinent according to the ICS definition. The mean value of the ICIQ-SF was 10.87 (±4). 17.8% of patients use at least one pad/day, 11.9% use more than one pad/day. The preoperative factors independently influential in UI are: age OR: 1.055; CI 95% (1.006–1.107), p?=?.028], urethral wall thickness OR: 5.03; CI 95% (1.11–22.8), p?=?.036], history of transurethral resection of the prostate OR: 6.13; CI 95% (1.86–20.18), p?=?.003] and membranous urethral length OR: 0.173; CI 95% (0.046–0.64), p?=?.009]. The predictive accuracy of the model is 78.7% and the area under the curve (AUC) value 71.7%.

Conclusions: Urinary incontinence after radical prostatectomy has different prevalence depending on the definition. Age, prior transurethral resection of the prostate (TURP), membranous urethral length (MUL) and urethral wall thickness (UWT) were risk factors.
Keywords:Radical prostatectomy  urinary incontinence  nomogram  prediction  magnetic resonance imaging  prostate cancer
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