The location of the bladder neck in postoperative cystography predicts continence convalescence after radical prostatectomy
Abstract Background This study was conducted to determine whether the location of the bladder neck in postoperative cystography predicts recovery of continence after radical prostatectomy. Methods Between 2008 and 2015, 203 patients who underwent laparoscopic radical prostatectomy (LRP, n = 99) and...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-05-01
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| Series: | BMC Urology |
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| Online Access: | http://link.springer.com/article/10.1186/s12894-018-0370-3 |
| _version_ | 1818542713207783424 |
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| author | Susumu Kageyama Tetsuya Yoshida Masayuki Nagasawa Shigehisa Kubota Keiji Tomita Kenichi Kobayashi Ryosuke Murai Teruhiko Tsuru Eiki Hanada Kazuyoshi Johnin Mitsuhiro Narita Akihiro Kawauchi |
| author_facet | Susumu Kageyama Tetsuya Yoshida Masayuki Nagasawa Shigehisa Kubota Keiji Tomita Kenichi Kobayashi Ryosuke Murai Teruhiko Tsuru Eiki Hanada Kazuyoshi Johnin Mitsuhiro Narita Akihiro Kawauchi |
| author_sort | Susumu Kageyama |
| collection | DOAJ |
| description | Abstract Background This study was conducted to determine whether the location of the bladder neck in postoperative cystography predicts recovery of continence after radical prostatectomy. Methods Between 2008 and 2015, 203 patients who underwent laparoscopic radical prostatectomy (LRP, n = 99) and robot assisted radical prostatectomy (RARP, n = 104) were analyzed. The location of the bladder neck was visualized by postoperative routine cystography, and quantitative evaluation of the bladder neck position was performed according to the bladder neck to pubic symphysis (BNPS) ratio proposed by Olgin et al. (J Endourol, 2014). Recovery of continence was defined as no pad use or one security pad per day. To determine the predictive factors for recovery of continence at 1, 3, 6 and 12 months, several parameters were analyzed using logistic regression analysis, including age (≤68 vs. > 68, BMI (≤23.4 vs. > 23.4 kg/m2), surgical procedure (LRP vs. RARP), prostate volume (≤38 vs. > 38 mL), nerve-sparing technique, vesico-urethral anastomosis leakage, and BNPS ratio (≤0.59 vs. > 0.59). Results The mean postoperative follow-up was 1131 days (79–2880). At 1, 3, 6 and 12 months after surgery, continence recovery rates were 25, 53, 68 and 81%, respectively. Although older age (> 68) and RARP were significant risk factors for incontinence within 3 months, neither was significant after 6 months. A high BNPS ratio (> 0.59) was the only significant risk factor for the persistence of incontinence at all observation points, up to 12 months. Conclusions A lower bladder neck position after prostatectomy predicts prolonged incontinence. |
| first_indexed | 2024-12-11T22:25:44Z |
| format | Article |
| id | doaj.art-26e7fcdbbaf445839b1c25a960e231ce |
| institution | Directory Open Access Journal |
| issn | 1471-2490 |
| language | English |
| last_indexed | 2024-12-11T22:25:44Z |
| publishDate | 2018-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Urology |
| spelling | doaj.art-26e7fcdbbaf445839b1c25a960e231ce2022-12-22T00:48:17ZengBMCBMC Urology1471-24902018-05-011811710.1186/s12894-018-0370-3The location of the bladder neck in postoperative cystography predicts continence convalescence after radical prostatectomySusumu Kageyama0Tetsuya Yoshida1Masayuki Nagasawa2Shigehisa Kubota3Keiji Tomita4Kenichi Kobayashi5Ryosuke Murai6Teruhiko Tsuru7Eiki Hanada8Kazuyoshi Johnin9Mitsuhiro Narita10Akihiro Kawauchi11Department of Urology, Shiga University of Medical ScienceDepartment of Urology, Shiga University of Medical ScienceDepartment of Urology, Shiga University of Medical ScienceDepartment of Urology, Shiga University of Medical ScienceDepartment of Urology, Shiga University of Medical ScienceDepartment of Urology, Shiga University of Medical ScienceDepartment of Urology, Shiga University of Medical ScienceDepartment of Urology, Shiga University of Medical ScienceDepartment of Urology, Shiga University of Medical ScienceDepartment of Urology, Shiga University of Medical ScienceDepartment of Urology, Shiga University of Medical ScienceDepartment of Urology, Shiga University of Medical ScienceAbstract Background This study was conducted to determine whether the location of the bladder neck in postoperative cystography predicts recovery of continence after radical prostatectomy. Methods Between 2008 and 2015, 203 patients who underwent laparoscopic radical prostatectomy (LRP, n = 99) and robot assisted radical prostatectomy (RARP, n = 104) were analyzed. The location of the bladder neck was visualized by postoperative routine cystography, and quantitative evaluation of the bladder neck position was performed according to the bladder neck to pubic symphysis (BNPS) ratio proposed by Olgin et al. (J Endourol, 2014). Recovery of continence was defined as no pad use or one security pad per day. To determine the predictive factors for recovery of continence at 1, 3, 6 and 12 months, several parameters were analyzed using logistic regression analysis, including age (≤68 vs. > 68, BMI (≤23.4 vs. > 23.4 kg/m2), surgical procedure (LRP vs. RARP), prostate volume (≤38 vs. > 38 mL), nerve-sparing technique, vesico-urethral anastomosis leakage, and BNPS ratio (≤0.59 vs. > 0.59). Results The mean postoperative follow-up was 1131 days (79–2880). At 1, 3, 6 and 12 months after surgery, continence recovery rates were 25, 53, 68 and 81%, respectively. Although older age (> 68) and RARP were significant risk factors for incontinence within 3 months, neither was significant after 6 months. A high BNPS ratio (> 0.59) was the only significant risk factor for the persistence of incontinence at all observation points, up to 12 months. Conclusions A lower bladder neck position after prostatectomy predicts prolonged incontinence.http://link.springer.com/article/10.1186/s12894-018-0370-3Bladder neck locationRadical prostatectomyContinence recovery |
| spellingShingle | Susumu Kageyama Tetsuya Yoshida Masayuki Nagasawa Shigehisa Kubota Keiji Tomita Kenichi Kobayashi Ryosuke Murai Teruhiko Tsuru Eiki Hanada Kazuyoshi Johnin Mitsuhiro Narita Akihiro Kawauchi The location of the bladder neck in postoperative cystography predicts continence convalescence after radical prostatectomy BMC Urology Bladder neck location Radical prostatectomy Continence recovery |
| title | The location of the bladder neck in postoperative cystography predicts continence convalescence after radical prostatectomy |
| title_full | The location of the bladder neck in postoperative cystography predicts continence convalescence after radical prostatectomy |
| title_fullStr | The location of the bladder neck in postoperative cystography predicts continence convalescence after radical prostatectomy |
| title_full_unstemmed | The location of the bladder neck in postoperative cystography predicts continence convalescence after radical prostatectomy |
| title_short | The location of the bladder neck in postoperative cystography predicts continence convalescence after radical prostatectomy |
| title_sort | location of the bladder neck in postoperative cystography predicts continence convalescence after radical prostatectomy |
| topic | Bladder neck location Radical prostatectomy Continence recovery |
| url | http://link.springer.com/article/10.1186/s12894-018-0370-3 |
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