1. FACTORS RELATED WITH URINARY INCONTINENCE GRADE AFTER RADICAL PROSTATECTOMY
Padilla Fernández, B.1; Virseda Rodríguez, ÁJ2; Pereira, BJ3, Coelho, H4,; Montesino Semper, M5, Müller Arteaga, C6, Álvarez-Ossorio Fernández, JL7, Migliorini, F8; García Cenador, MB9; Antúnez Plaza, P10; Silva Abuín, JM11; Lorenzo Gómez, A9; Santos Antunes, MT9; Mirón Canelo, JA12; Lorenzo Gómez, MF2,9.
1Urology Department of the University Hospital of the Canary Islands. Tenerife. Spain. 2Urology Department of the University Hospital of Salamanca. Spain. 3Urology Department of the University Hospital of Pêro da Covilhã, Covilhã. Portugal. 4Centro Hospitalar e Universitário de Coimbra (CHUC). Portugal. 5Urology Department of the University Hospital “Virgen del Camino”. Pamplona. Spain. 6Urology Department of the University Hospital of Ourense. Spain. 8Urology Department of the University Hospital “Puerta del Mar”. Cádiz. Spain. 8Urology Department of the “Azienda Ospedaliera Universitaria Integrata”. Verona. Italy. 9Surgery Department of the University of Salamanca. Spain. 10Pathology Department of the University Hospital of Salamanca. Spain. 11Urology Department of the "San Pedro" Hospital. Logroño. Spain. 12Preventive Medicine and Public Health Department of the University of Salamanca. Spain.
METHODOLOGY
Retrospective multicentric study.
Patients who underwent radical prostatectomy between March 2009 and March 2013 in seven hospitals (2 level-four hospitals and 5 tertiary hospitals).
Variables: Age, PSA, presurgical LUTS, BMI, technique [laparoscopic (LP), open retropubic (OP), robot-assisted (RobP)], pTNM, post-surgical Gleason score, margins complications, UI prevalence and grade.
Statistics: Descriptive statistics, Student’s t-test,Fischer’s exact test, Chi-Square. p<0.05 was accepted as significant.
Classification according to IU severity assessed by the pad test:
- Mild: < 100 g/24 hours (LUI) ;
- Moderate: g/24 hours (MUI);
- Severe: > 400 g/24 hours (SUI).
OBJECTIVES
To analyze the prevalence of post-surgical urinary incontinence (UI), technical and pathological variations and UI severity in a multicentric study.
RESULTS
265 patients.
Average age years (45-72).
Level-four hospitals: RobP12.50%, OP45%, LP42.50%.
Tertiary hospitals: OP63.82%, LP37.17%.
Post-surgical UI was present in 40%: 57 LUI (53.65%), 34 MUI (31.70%), 15 SUI (14.63%).
Greater age (p=0.0032), higher PSA (p=0.0018), more complication in immediate and deferred postoperative period (p=0.0026) and higher pTNM (p=0.0019) were found in group SUI.
No differences were found when comparing technique, time keeping the urethral catheter, prostate volume, Gleason score, affected margins, complementary radio- or hormone-therapy (Comp).
Table 1. Value and distribution of variables in patients with UI.
Group
PSA
pT2a%
pT2b%
pT2c%
pT3a%
pT3b%
Comp%
LUI
8.27
4.54
27.27 50
9.09
13.63
MUI
8.60
15.38
53.84
23.07
SUI
12.01
16.66
33.32
33.33 p
0.0018
0.0019
0.0026
CONCLUSIONS
Higher pTNM stage and local complications related with the surgery have a greater association with more severe UI than affected margins or prostate volume. Wider studies are needed to confirm these results.