Preoperative magnetic resonance imaging pelvic and prostatic parameters predict long-term urinary continence after Retzius-sparing robot-assisted radical prostatectomy

To assess the prognostic value of preoperative magnetic resonance imaging (MRI)-derived pelvic and prostatic parameters for long-term urinary continence (UC) following Retzius-sparing robot-assisted radical prostatectomy (RS-RARP). 253 patients who underwent RS-RARP by a single surgeon were retrospectively collected for analyses. MRI parameters reflecting the transverse and anteroposterior diameters of the pelvis, as well as the depth of the prostate, were measured. Univariate and multivariate Cox regression analyses were performed to identify predictors of long-term UC. Immediate UC was achieved in 49.4% of patients, with cumulative rates increasing to 95.3% by 12 months postoperatively. Multivariate analysis identified age, tuberous width index (TWI), and clinical T3 stage as independent predictors of long-term UC after RS-RARP. The TWI, derived from preoperative MRI, is a novel predictor of long-term urinary continence following RS-RARP. Integration of TWI with established clinical parameters into a predictive model can aid in preoperative counseling and surgical planning.