TY  - JOUR
A1  - Wenzel, Mike
A1  - Preißer, Felix Martin
A1  - Mueller, Matthias
A1  - Theißen, Lena Hermine
A1  - Welte, Maria-Noemi
A1  - Höh, Robert Benedikt
A1  - Humke, Clara Julia
A1  - Bernatz, Simon
A1  - Bodelle, Boris
A1  - Würnschimmel, Christoph
A1  - Tilki, Derya
A1  - Huland, Hartwig
A1  - Graefen, Markus
A1  - Roos, Frederik
A1  - Becker, Andreas
A1  - Karakiewicz, Pierre I.
A1  - Chun, Felix
A1  - Kluth, Luis
A1  - Mandel, Philipp
T1  - Effect of prostatic apex shape (Lee types) and urethral sphincter length in preoperative MRI on very early continence rates after radical prostatectomy
T2  - International urology and nephrology
N2  - Purpose: To test the effect of anatomic variants of the prostatic apex overlapping the membranous urethra (Lee type classification), as well as median urethral sphincter length (USL) in preoperative multiparametric magnetic resonance imaging (mpMRI) on the very early continence in open (ORP) and robotic-assisted radical prostatectomy (RARP) patients. Methods: In 128 consecutive patients (01/2018–12/2019), USL and the prostatic apex classified according to Lee types A–D in mpMRI prior to ORP or RARP were retrospectively analyzed. Uni- and multivariable logistic regression models were used to identify anatomic characteristics for very early continence rates, defined as urine loss of ≤ 1 g in the PAD-test. Results: Of 128 patients with mpMRI prior to surgery, 76 (59.4%) underwent RARP vs. 52 (40.6%) ORP. In total, median USL was 15, 15 and 10 mm in the sagittal, coronal and axial dimensions. After stratification according to very early continence in the PAD-test (≤ 1 g vs. > 1 g), continent patients had significantly more frequently Lee type D (71.4 vs. 54.4%) and C (14.3 vs. 7.6%, p = 0.03). In multivariable logistic regression models, the sagittal median USL (odds ratio [OR] 1.03) and Lee type C (OR: 7.0) and D (OR: 4.9) were independent predictors for achieving very early continence in the PAD-test. Conclusion: Patients’ individual anatomical characteristics in mpMRI prior to radical prostatectomy can be used to predict very early continence. Lee type C and D suggest being the most favorable anatomical characteristics. Moreover, longer sagittal median USL in mpMRI seems to improve very early continence rates.
KW  - ORP
KW  - RARP
KW  - Lee type, functional outcome
KW  - PAD-test
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/63664
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-636647
SN  - 1573-2584
N1  - Open Access funding enabled and organized by Projekt DEAL. The authors declare that this study had no funding.
VL  - 53
IS  - 7
SP  - 1297
EP  - 1303
PB  - Springer Science + Business Media B.V.
CY  - Dordrecht [u.a.]
ER  -