Duration and Influencing Factors of Postoperative Urinary Incontinence after Robot-Assisted Radical Prostatectomy in a Japanese Community Hospital: A Single-Center Retrospective Cohort Study
Tadashi Kasai, Taro Banno, Kazutaka Nakamura, Yukiko Kouchi, Haruki Shigeta, Fumio Suzuki, Yudai Kaneda, Divya Bhandari, Anju Murayama, Katumori Takamatsu, Naomi Kobayashi, Toyoaki Sawano, Yoshitaka Nishikawa, Hiroyuki Sato, Akihiko Ozaki, Tomohiro Kurokawa, Norio Kanzaki, Hiroaki Shimmura
Abstract
OBJECTIVES: Post-operative urinary incontinence (PUI) after robotic-assisted radical prostatectomy (RARP) is an important complication; PUI occurs immediately after postoperative urethral catheter removal, and, although approximately 90% of patients improve within one year after surgery, it can significantly worsen their quality of life. However, information is lacking on its nature in community hospital settings, particularly in Asian countries. The purposes of this study were to investigate the time required to recover from PUI after RARP and to identify its associated factors in a Japanese community hospital. METHODS: Data were extracted from the medical records of 214 men with prostate cancer who underwent RARP from 2019 to 2021. We then calculated the number of days elapsed from the surgery to the initial outpatient visit confirming PUI recovery among the patients. We estimated the PUI recovery rate using the Kaplan-Meier product limit method and evaluated associated factors using the multivariable Cox proportional hazards model. RESULTS: The PUI recovery rates were 5.7%, 23.4%, 64.6%, and 93.3% at 30, 90, 180, and 365 days following RARP, respectively. After an adjustment, those with preoperative urinary incontinence experienced significantly slower PUI recovery than their counterparts, while those with bilateral nerve sparing experienced recovery significantly sooner than those with no nerve sparing. CONCLUSION: Most PUI improved within one year, but a proportion of those experiencing recovery before 90 days was smaller than previously reported.