Postoperative Urinary Continence And Risk Factors After Radical Prostatectomy (Report Of153Cases)

Purpose Urinary incontinence is one of the common postoperative complications ofradical prostatectomy and is also the most important factor which affect the quality of lifeof patients．There are many factors that may influence the urinary continence after radicalprostatectomy, including objective clinical characteristics, surgical techniques and earlyfunction rehabilitation. The purpose of this issue is to evaluate urinary continenceoutcomes after radical prostatectomy, and identify risk factors at the same time.Methods From June2007to June2013,153patients with organ confined prostate cancer(TNM stage of T1c-T2c) underwent radical prostatectomy (55by the radical retropubicprostatectomy(RRP) and98by the laparoscopic radical prostatectomy(LRP)).After reviewall The clinical data and close follow-up about urinary continence function, we useunivariate and multivariate analyses to exam risk factors associated with incontinence in allthese patients.Results153operations were all successfully performed. The continence rate for the RRPwas12.7%(7/55) and69.1%(38/55); while LRP was17.3%(17/98) and74.5%(73/98) at4weeks and12weeks post-operation. After12weeks, the continence rate between twogroups were basically unchanged,48-week continence rate reached to92.7%(51/55) and93.9%(92/98). Cox proportional hazards regression analysis revealed that age atsurgery(P=0.031), previous TURP(P=0.014), neoadjuvant hormonal therapy(P=0.022),prostate gland size(P=0.039) and nerve sparing technique were the important risk factors。Conclusion The recovery of continence after radical prostatectomy is slow andincremental, vast majority of patients performed well in urinary continence at48week.Throughout the study, we find that the most important recovery interval for urinarycontinence was4to12weeks post-operation, surgical method had no effect onperioperative outcomes, however, recovery of postoperative continence can be delayed in patients with RRP. Age at surgery, previous TURP and nerve sparing technique are theindependent prognostic factors. Neoadjuvant hormonal therapy and prostate gland sizemay influence postoperative urinary continence through other influencing factors.