Predictive factors from videourodynamic study for delayed urinary continence after laparoscopic radical prostatectomy

PurposeTo search for risk factors for delayed urinary continence after laparoscopic radical prostatectomy (LRP).Materials and methodsPatients who received LRP for localized prostate cancer between January 2011 and December 2013 were enrolled. All patients were evaluated with a detailed history, physical examination, and videourodynamic study (VUDS) prior to the operation. After surgery, they were followed up in the outpatient department at 1 month, 3 months, 6 months, and 12 months. The clinical patient data and VUDS parameters were compared between subgroups of patients with and without stress urinary incontinence (SUI), urgency, or urgency urinary incontinence (UUI) according to their clinical symptoms 6 months after surgery.ResultsA total of 48 patients with a mean age of 72.1 ± 5.68 years were enrolled. Patients with SUI had a larger mean baseline total prostate volume (TPV) (61.42 ± 30.4 mL vs. 45.64 ± 19.98 mL, p = 0.04), higher cancer stage (47.6% vs. 18.5%, p = 0.031), and longer operation time (269.95 ± 52.17 minutes vs. 230.15 ± 48.77 minutes, p = 0.011) than those without SUI. Most baseline VUDS parameters were not significantly different between SUI and non-SUI subgroups except for full sensation (FS; p = 0.037) and the presence of bladder outlet obstruction (BOO; 52.4% vs. 22.2%, p = 0.038). Patients with urgency had a higher maximal flow rate (p = 0.046) than those without. Patients with postoperative UUI had a larger first sensation of filling (FSF; p = 0.035) than those without. Interestingly, baseline urodynamic detrusor overactivity (DO) and BOO did not have an impact on postoperative urgency or UUI. Multivariate analysis showed no parameters which predicted SUI, urgency, or UUI after radical prostatectomy.ConclusionPreoperative small bladder capacity at FS, large prostate, and BOO are predicting factors of SUI at 6 months after LRP. Baseline DO and BOO did not have an impact on postoperative urgency or UUI.