Association of preoperative urethral parameters on magnetic resonance imaging and immediate recovery of continence following Retzius-sparing robot-assisted radical prostatectomy

被引：9

作者：

Li, Youjian ^{[1
,2
]}

Li, Weijian ^{[1
,2
]}

Lu, Wenfeng ^{[1
,2
]}

Chen, Mengxia ^{[1
,2
]}

Gao, Jie ^{[1
,2
]}

Yang, Yang ^{[1
,2
]}

Zhuang, Junlong ^{[1
,2
]}

Li, Xiaogong ^{[1
,2
]}

Guo, Hongqian ^{[1
,2
]}

Qiu, Xuefeng ^{[1
,2
]}

机构：

[1] Nanjing Univ, Dept Urol, Drum Tower Hosp, Med Sch, Nanjing 210008, Peoples R China

[2] Nanjing Univ, Inst Urol, Nanjing 210008, Peoples R China

来源：

TRANSLATIONAL ANDROLOGY AND UROLOGY | 2020年 / 9卷 / 02期

基金：

中国国家自然科学基金;

关键词：

Immediate urinary continence; magnetic resonance imaging (MRI); prostate cancer; radical prostatectomy (RP); Retzius sparing; QUALITY-OF-LIFE; URINARY CONTINENCE; LENGTH; INCONTINENCE; PREDICTORS; IMPACT; CANCER;

D O I：

10.21037/tau.2019.12.17

中图分类号：

R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

摘要：

Background: Studies regarding predictive factors of urinary continence following Retzius-sparing radical prostatectomy (RP) is limited. This study was designed to evaluate association of urethral parameters on preoperative magnetic resonance imaging (MRI) and immediate recovery of urinary continence following Retzius-sparing robot assisted radical prostatectomy (RS-RARP). Methods: This retrospective cohort study enrolled 156 patients with clinically localized prostate cancer who underwent MRI before RS-RARP. We measured the following structures on preoperative MRI: minimal residual membranous urethral length (mRUL), peri-urethral sphincter complex (PSC) thickness, urethral wall thickness (UWT), the thicknesses of the levator ani muscle (LAM) and obturator internus muscle (OIM). Immediate urinary continence was defined as patients reported freedom from using safety pad within 7 days after removal of urinary catheter. Patients were divided into two groups according the median of each parameter on MRI. We retrospectively analyzed the patients in term of preoperative clinical factors and postoperative urinary continence. Results: A total of 100 patients (64.1%) reported immediate urinary continence after RS-RARP. Immediate urinary continence was significantly more in patients with longer mRUL (>= 8.70 mm) than in patients with shorter mRUL (<8.70 mm; P=0.000). On multivariable analysis, longer mRUL was significantly related to immediate urinary continence after RS-RAPA (odds ratio 8.265; P=0.000). PSC, UWT, LAM and OIM were not associated with immediate urinary continence. Conclusions: Our results firstly demonstrated that preoperative mRUL measured on MRI was an independent predictor of immediate urinary continence following RS-RARP. Therefore, preservation of membranous urethra is still the anatomical basis of better urinary outcome after RS-RARP.

引用

页码：501 / 509

页数：9

共 28 条

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