Predictors of short-term recovery of urinary continence after radical prostatectomy

To evaluate treatment variables for early urinary continence status 6 weeks following radical prostatectomy. In this retrospective analysis, 4,028 consecutive patients underwent open radical retropubic (RRP) or robot-assisted transperitoneal prostatectomy (RARP) at a single academic institution (07/2003-07/2013). After discharge, patients were offered 3-week treatment in a rehabilitation facility. Patients who opted for rehabilitation (n = 2,998, 74.4 %) represent our study cohort. Exclusion criteria were acute urinary retention after catheter removal (n = 55, 1.4 %), incomplete datasets (n = 50, 1.2 %) or refusal of rehabilitation (n = 925, 23.0 %). Results of urinary continence were evaluated from final rehabilitation reports. Twenty-two clinical and oncological variables were statistically analysed in uni- and multivariable analyses to determine whether they were associated with early urinary continence status six weeks after radical prostatectomy. Odds ratios and 95 % CI as well as p values were calculated. A p level of 0.05 was considered as significant. Six weeks after surgery, 1,962 (65.4 %) patients were continent (a parts per thousand currency sign1 pad/day) and 1,036 (34.6 %) patients were considered incontinent. Age, clinical stage, PSA, ASA score, prior TURP, seminal vesicle invasion, Gleason score, nerve-sparing status, intraoperative blood loss, catheterisation time, OR time, surgical caseload > 1,000 and the surgeon were associated with continence status on univariable analysis (p < 0.05). On multivariable analysis, nerve-sparing procedure (NS), clinical stage, individual surgeon, patient age, surgical procedure (RARP vs. RRP) and duration of catheterisation were independent predictors (p < 0.05) of incontinence status. Strategies that can ensure NS procedures and early catheter removal should be applied to enable early recovery of urinary continence.