Category: Urinary Incontinence: Outcomes & Complications
Introduction & Objective :
The pad count to evaluate postoperative continence status is not objective and varies according to personal tolerance. The International Consultation on Incontinence Questionnaire (ICIQ) as a measure of continence outcome after robot-assisted laparoscopic radical prostatectomy (RARP) was evaluated and correlations with various factors were assessed.
167 patients who had undergone RARP by a single surgeon from 2010 to 2017 were enrolled. The patients who had adjuvant RT or ADT was excluded. ICIQ and pad count was assessed during postoperative 1mo, 3mo and 6mo. The patient and surgical factors including age, prostate volume, BMI, IPSS, nerve sparing, bladder neck preservation, and puboprostatic ligament saving were evaluated. The correlation between each factors and ICIQ outcome was analyzed using Mann-Whitney test and Spearman correlation analysis. The whole data were prospectively collected and analyzed retrospectively.
ICIQ scores at postoperative 1mo, 3mo and 6mo were 7.7±5.84, 5.8±5.12 and 5.4±3.95 respectively. ICIQ scores at postoperative 1 mo were 9.93±6.0 for non-nerve saving group, 7.5±6.1 for unilateral nerve saving group and 7.15±5.6 for bilateral nerve saving group (p<0.05). The factors showed a significant correlation with ICIQ scores at postoperative 1mo and 3 mo were prostate volume, preoperative IPSS and nerve saving. However, these correlations with ICIQ were disappeared at postoperative 6mo except preoperative IPSS. The preservation of bladder neck, puboprostatic ligament, and Rocco stitch failed to show the correlation with postoperative ICIQ score throughout the whole postoperative period.
The preservation of neurovascular bundle was the only significant surgical factor that showed correlation with ICIQ score of early postoperative period after RARP.
Taesoo Choi– Kyung Hee University Hospital, Seoul, Seoul-t'ukpyolsi, Republic of Korea
Sang Hyup Lee– Kyung Hee University Hospital, Seoul, Seoul-t'ukpyolsi, Republic of Korea
Koo Han Yoo– Kyung Hee University Hospital, Seou., Seoul-t'ukpyolsi, Republic of Korea
Seung Hyun Jeon– Professor, Kyung Hee University Hospital, Seoul, Seoul-t'ukpyolsi, Republic of Korea