Category: Laparoscopic/ Robotic: Prostate

MP20-2 - What Parameters Affect Continence after Robot Assisted Laparoscopic Radical Prostatectomy?

Sat, Sep 22
2:00 PM - 4:00 PM

Introduction & Objective :

Urinary incontinence (UI) is a frequent complication of radical prostatectomy and has a substantial negative impact on mental health and overall quality of life. We aimed to assess what factors were associated with UI in a cohort of patients undergoing robot-assisted laparoscopic radical prostatectomy.


Methods :

Data was prospectively collected for 605 consecutive patients undergoing robot-assisted laparoscopic radical prostatectomy by a single surgeon. UI outcomes (quantification of pad use and ICIQ-SF score) were collected at 6 weeks, 3, 6, 12, 18 and 24 months post-operatively and we used univariate and multivariate regression models to evaluate the association with age, body mass index (BMI), prostate volume, previous prostate surgery, pre-operative UI, nerve-sparing status, preservation of the bladder neck, training cases, extended lymph node dissections and surgeon experience.


Results :

The median age was 65 years (IQR 60-68 years). At 24 months 85.7% were continent by the 0 or 1 safety pad definition, with a median ICIQ-SF score of 0 (IQR 0-4) but 46.0% reported any degree of UI. Increasing age was significantly associated with increased incontinence pad use post-operatively as was previous prostate surgery up to 12 months follow-up. Increased pre-operative ICIQ-SF scores were associated with increased post-operative ICIQ-SF scores. There was trend to improved UI outcomes with bilateral preservation of the neurovascular bundles but this was not significant on the multivariate model. No other parameters were associated with UI outcomes.


Conclusions :

In our cohort increasing age, pre-operative UI and previous prostate surgery were associated with worse post-operative UI after robot-assisted laparoscopic radical prostatectomy.

Niyati Lobo

Urology Registrar
East Kent Hospitals University NHS Foundation Trust
Canterbury, England, United Kingdom

Ian Rudd


Eastbourne, England, United Kingdom

Matthew Stanowski

Laparoscopic and Robotic Fellow
Canterbury Centre for Robotic Urological Surgery. East Kent Hospitals University NHS Foundation Trust.
Canterbury, England, United Kingdom

Sashi S. Kommu

Consultant Urological Surgeon
Canterbury Centre for Robotic Urological Surgery. East Kent Hospitals University NHS Foundation Trust.
Canterbury, England, United Kingdom

Julie Pain


Canterbury, England, United Kingdom

Ben Eddy

Consultant Urologist
East Kent Hospitals University NHS Foundation Trust
Canterbury, England, United Kingdom