Predictors for immediate recovery of continence following Retzius-sparing robot-assisted radical prostatectomy: a case-control study

Purpose We evaluated urinary continence in a series of consecutive patients who underwent Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) to identify the preoperative predictors of the return to immediate urinary continence. Methods 110 consecutive patients who underwent RS-RARP for clinically localized prostate cancer were retrospectively collected. Patients reported freedom from using safety pad (0pad/day) within 7days after removal of urinary catheter were defined as immediate urinary continent. Results A total of 85 patients (77.27%) were immediate urinary continent after RS-RARP. Patients with immediate urinary continence were significantly younger (66.92 +/- 5.73 vs. 69.68 +/- 4.99 years, p=0.031) than those who were incontinent. Furthermore, the prostate volume was significantly smaller (30.90 vs. 44.60 ml, p=0.001) and preoperative international prostate symptom score (IPSS) was significantly lower (Mild 76.5% vs. 24.0%, Moderate 20.0% vs. 32.0%, and Severe 3.5% vs. 44.0%, p=0.000) in patients with immediate urinary continence compared with those who were not. On univariable regression analysis, patient's age (OR 0.907, p=0.035), prostate volume (OR 0.935, p=0.000), moderate (OR 0.196, p=0.007), and severe IPSS (OR 0.025, p=0.000) (compared with mild IPSS) were independent adverse predictors of immediate urinary continence. On multivariable analysis, prostate volume (OR 0.955, p=0.032) and severe preoperative IPSS (OR 0.044, p=0.000) (compared with mild IPSS) were independent adverse predictors of immediate urinary continence after RS-RARP. Conclusions RS-RARP hastens the recovery of urinary continence after surgery. Prostate volume and severe preoperative IPSS were independent adverse predictors of the return to immediate urinary continence.