Very early continence after radical prostatectomy and its influencing factors

  • Introduction and Objectives: Surgical techniques such as preservation of the full functional-length of the urethral sphincter (FFLU) have a positive impact on postoperative continence rates. Thereby, data on very early continence rates after radical prostatectomy (RP) are scarce. The aim of the present study was to analyze very early continence rates in patients undergoing FFLU during RP. Materials and Methods: Very early-continence was assessed by using the PAD-test within 24 h after removal of the transurethral catheter. The PAD-test is a validated test that measures the amount of involuntary urine loss while performing predefined physical activities within 1 h (e.g., coughing, walking, climbing stairs). Full continence was defined as a urine loss below 1 g. Mild, moderate, and severe incontinence was defined as urine loss of 1–10 g, 11–50 g, and >50 g, respectively. Results: 90 patients were prospectively analyzed. Removal of the catheter was performed on the 6th postoperative day. Proportions for no, mild, moderate and severe incontinence were 18.9, 45.5, 20.0, and 15.6%, respectively. In logistic regression younger age was associated with significant better continence (HR 2.52, p = 0.04), while bilateral nerve-sparing (HR 2.56, p = 0.057) and organ-confined tumor (HR 2.22, p = 0.078) showed lower urine loss, although the effect was statistically not significant. In MVA, similar results were recorded. Conclusion: Overall, 64.4% of patients were continent or suffered only from mild incontinence at 24 h after catheter removal. In general, reduced urine loss was recorded in younger patients, patients with organ-confined tumor and in patients with bilateral nerve sparing. Severe incontinence rates were remarkably low with 15.6%.

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Author:Lena TheißenORCiDGND, Felix Martin PreißerORCiDGND, Mike WenzelORCiDGND, Clara Julia HumkeGND, Frederik RoosGND, Luis KluthORCiDGND, Andreas BeckerGND, Séverine BanekGND, Boris BodelleORCiDGND, Jens KöllermannORCiDGND, Felix ChunORCiDGND, Philipp MandelORCiDGND
Pubmed Id:
Parent Title (English):Frontiers in Surgery
Publisher:Frontiers Media
Place of publication:Lausanne
Contributor(s):Clemens Mathias Rosenbaum
Document Type:Article
Year of Completion:2019
Date of first Publication:2019/10/25
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2020/01/13
Tag:FFLU; catheter removal; early continence; nerve-sparing; radical prostatectomy
Issue:Art. 60
Page Number:5
First Page:1
Last Page:5
Copyright © 2019 Theissen, Preisser, Wenzel, Humke, Roos, Kluth, Becker, Banek, Bodelle, Köllermann, Chun and Mandel. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0