Bladder neck size and its association with urinary continence after robot‐assisted radical prostatectomy
Abstract Objectives This study aims to determine whether bladder neck size (BNS) measured during surgery is associated with urinary continence after robot‐assisted radical prostatectomy. Patients and Methods Between June 2015 and March 2019, 365 consecutive eligible patients undergoing robot‐assiste...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-03-01
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| Series: | BJUI Compass |
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| Online Access: | https://doi.org/10.1002/bco2.188 |
| _version_ | 1797905392817143808 |
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| author | Yasuo Kohjimoto Masatoshi Higuchi Shimpei Yamashita Kazuro Kikkawa Isao Hara |
| author_facet | Yasuo Kohjimoto Masatoshi Higuchi Shimpei Yamashita Kazuro Kikkawa Isao Hara |
| author_sort | Yasuo Kohjimoto |
| collection | DOAJ |
| description | Abstract Objectives This study aims to determine whether bladder neck size (BNS) measured during surgery is associated with urinary continence after robot‐assisted radical prostatectomy. Patients and Methods Between June 2015 and March 2019, 365 consecutive eligible patients undergoing robot‐assisted radical prostatectomy were enrolled into a prospective observational cohort study. The primary outcome was patient‐reported urinary continence status at 1, 3, 6, 12 and 24 months postoperatively, with continence defined as 0 pad/day. The primary exposure was BNS (largest diameter) measured intraoperatively just before performance of vesicourethral anastomosis. Other covariates included age, body mass index, NCCN risk category, nerve‐sparing, membranous urethral length measured intraoperatively and weight of the resected specimen. Results Well‐preserved neurovascular bundle (bilateral/unilateral/none) was highly correlated with urinary continence status at every point after surgery. No difference could be seen between the group with BNS ≤17 mm and the >17‐mm group at 1, 3 and 6 months after surgery, but there was better urinary rate of continence in narrow BNS group (≤17 mm) at 12 and 24 months after surgery. Multivariate analysis showed both nerve sparing and bladder neck diameter to be independent factors affecting urinary continence at 12 and 24 months after surgery. Conclusion Preservation of neurovascular bundles was associated with better urinary continence after surgery. Smaller BNS was associated with better urinary continence in late stages after surgery (12–24 months after surgery). |
| first_indexed | 2024-04-10T10:04:32Z |
| format | Article |
| id | doaj.art-62d86ab9e7cf40a390afa83222abddb9 |
| institution | Directory Open Access Journal |
| issn | 2688-4526 |
| language | English |
| last_indexed | 2024-04-10T10:04:32Z |
| publishDate | 2023-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | BJUI Compass |
| spelling | doaj.art-62d86ab9e7cf40a390afa83222abddb92023-02-16T02:44:43ZengWileyBJUI Compass2688-45262023-03-014218118610.1002/bco2.188Bladder neck size and its association with urinary continence after robot‐assisted radical prostatectomyYasuo Kohjimoto0Masatoshi Higuchi1Shimpei Yamashita2Kazuro Kikkawa3Isao Hara4Department of Urology Wakayama Medical University Wakayama JapanDepartment of Urology Wakayama Medical University Wakayama JapanDepartment of Urology Wakayama Medical University Wakayama JapanDepartment of Urology Wakayama Medical University Wakayama JapanDepartment of Urology Wakayama Medical University Wakayama JapanAbstract Objectives This study aims to determine whether bladder neck size (BNS) measured during surgery is associated with urinary continence after robot‐assisted radical prostatectomy. Patients and Methods Between June 2015 and March 2019, 365 consecutive eligible patients undergoing robot‐assisted radical prostatectomy were enrolled into a prospective observational cohort study. The primary outcome was patient‐reported urinary continence status at 1, 3, 6, 12 and 24 months postoperatively, with continence defined as 0 pad/day. The primary exposure was BNS (largest diameter) measured intraoperatively just before performance of vesicourethral anastomosis. Other covariates included age, body mass index, NCCN risk category, nerve‐sparing, membranous urethral length measured intraoperatively and weight of the resected specimen. Results Well‐preserved neurovascular bundle (bilateral/unilateral/none) was highly correlated with urinary continence status at every point after surgery. No difference could be seen between the group with BNS ≤17 mm and the >17‐mm group at 1, 3 and 6 months after surgery, but there was better urinary rate of continence in narrow BNS group (≤17 mm) at 12 and 24 months after surgery. Multivariate analysis showed both nerve sparing and bladder neck diameter to be independent factors affecting urinary continence at 12 and 24 months after surgery. Conclusion Preservation of neurovascular bundles was associated with better urinary continence after surgery. Smaller BNS was associated with better urinary continence in late stages after surgery (12–24 months after surgery).https://doi.org/10.1002/bco2.188bladder neckincontinenceprostate cancerprostatectomyurethral length |
| spellingShingle | Yasuo Kohjimoto Masatoshi Higuchi Shimpei Yamashita Kazuro Kikkawa Isao Hara Bladder neck size and its association with urinary continence after robot‐assisted radical prostatectomy BJUI Compass bladder neck incontinence prostate cancer prostatectomy urethral length |
| title | Bladder neck size and its association with urinary continence after robot‐assisted radical prostatectomy |
| title_full | Bladder neck size and its association with urinary continence after robot‐assisted radical prostatectomy |
| title_fullStr | Bladder neck size and its association with urinary continence after robot‐assisted radical prostatectomy |
| title_full_unstemmed | Bladder neck size and its association with urinary continence after robot‐assisted radical prostatectomy |
| title_short | Bladder neck size and its association with urinary continence after robot‐assisted radical prostatectomy |
| title_sort | bladder neck size and its association with urinary continence after robot assisted radical prostatectomy |
| topic | bladder neck incontinence prostate cancer prostatectomy urethral length |
| url | https://doi.org/10.1002/bco2.188 |
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