Possible predictor of early recovery on urinary continence after laparoscopic radical prostatectomy – Bladder neck level and urodynamic parameters

Background/Purpose: To investigate the relationship between post-operative bladder neck levels and urodynamic parameters and their effect on urinary incontinence after laparoscopic radical prostatectomy (LRP). Methods: Forty-eight consecutive patients undergoing LRP were retrospectively reviewed. Al...

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Bibliographic Details
Main Authors: Hsu-Che Huang, Yuan-Hong Jiang, Victor Chia-Hsiang Lin, Yao-Chou Tsai, Hann-Chorng Kuo
Format: Article
Language:English
Published: Elsevier 2019-01-01
Series:Journal of the Formosan Medical Association
Online Access:http://www.sciencedirect.com/science/article/pii/S0929664617305478
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Summary:Background/Purpose: To investigate the relationship between post-operative bladder neck levels and urodynamic parameters and their effect on urinary incontinence after laparoscopic radical prostatectomy (LRP). Methods: Forty-eight consecutive patients undergoing LRP were retrospectively reviewed. All patients were assessed using retrograde cystography after LRP and were grouped according to their bladder neck position: Level 0: at or above the superior margin of the symphysis pubis (SMSP); Level −1: at <2 cm below SMSP; and Level −2: at >2 cm below SMSP. Urodynamic studies were conducted at baseline as well as at 1 and 3 months post-operatively. Early recovery of urinary continence was defined as no urine leakage or only one pad/day used within 3 months after surgery. Demographic characteristics, changes in urodynamic parameters, and continence outcomes were analyzed. Results: Overall rate of early recovery of urinary continence was 33.3%. Patients with higher bladder neck levels experienced a significantly earlier recovery of urinary continence in univariate analysis (77.8%, 29.2%, and 13.3% for bladder neck levels 0, −1, and −2, respectively, p = 0.004). Patients with early recovery of urinary continence had significantly longer functional profile lengths (FPLs) 1 month post-surgery (21.0 mm vs 14.8 mm, p = 0.019). Higher bladder neck levels were significantly associated with longer FPLs at 1 month (p = 0.032). Conclusion: Bladder neck level is associated with FPLs at 1 month post-surgery, which is the possible predictor of early recovery of urinary continence after LRP. Patients with longer FPL at 1 month after LRP have a higher rate of early recovery of urine continence. Keywords: Prostatectomy, Urinary incontinence, Urodynamics
ISSN:0929-6646