Factors Affecting Return of Continence 3 Months After Robot-Assisted Radical Prostatectomy: Analysis From a Large, Prospective Data by a Single Surgeon

Imagem de Miniatura
Arquivos
art_COELHO_Factors_Affecting_Return_of_Continence_3_Months_After_2012.PDF (425.57 KB)
Citações na Scopus
57
Tipo de produção
article
Data de publicação
2012
Editora
ELSEVIER SCIENCE INC
DOI
Indexadores
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Autores
KO, Young Hwii
CHAUHAN, Sanket
SIVARAMAN, Ananthakrishnan
SCHATLOFF, Oscar
CHEON, Jun
PATEL, Vipul R.
Autor de Grupo de pesquisa
Editores
Coordenadores
Organizadores
Citação
JOURNAL OF UROLOGY, v.187, n.1, p.190-194, 2012
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Purpose: In this study we identified preoperative or intraoperative factors responsible for the early return of continence after robot-assisted radical prostatectomy using data from a high volume center. Materials and Methods: Data from 1,299 patients who underwent robot-assisted radical prostatectomy performed by a single surgeon from January 2008 to June 2010 were collected prospectively and analyzed retrospectively. Patients were categorized according to whether they regained continence (no pad and no urinary leakage) within 3 months and variables were then compared. A self-administered validated questionnaire (Expanded Prostate Cancer Index Composite) was used for assessment of continence status and time to recovery. Results: Within 3 months after surgery 86.3% of patients (1,121/1,299) had recovered continence. Multivariable Cox regression analysis revealed that only age (p < 0.001, hazard ratio 0.98, 95% CI 0.97-0.99) and performance of a nerve sparing procedure were independent predictors. After adjusting for age, the hazard ratio was 1.61 (95% CI 1.25-2.07, p < 0.001) for partial nerve sparing and 1.44 (1.13-1.83, p = 0.003) for bilateral nerve sparing compared to the nonnerve sparing group. Median time (95% CI) to the recovery of continence was prolonged in the nonnerve sparing group compared to nerve sparing counterparts at 6 (5.12-6.88), 4 (3.60-4.40) and 5 weeks (4.70-5.30) in the nonnerve sparing, partial nerve sparing and bilateral nerve sparing groups, respectively, with log rank p < 0.01. Conclusions: Findings from our analysis indicate that the likelihood of postoperative urinary control was significantly higher in younger patients and when a nerve sparing procedure was performed.
Palavras-chave
urinary incontinence, prostatectomy
URI
https://observatorio.fm.usp.br/handle/OPI/2594
Referências
  1. Burkhard FC, 2006, J UROLOGY, V176, P189, DOI 10.1016/S0022-5347(06)00574-X
  2. Coelho RF, 2009, BJU INT, V104, P1428, DOI 10.1111/j.1464-410X.2009.08895.x
  3. Coelho RF, 2011, EUR UROL, V59, P72, DOI 10.1016/j.eururo.2010.08.025
  4. Coughlin G, 2009, J ROBOT SURG, V1, P13
  5. Deliveliotis C, 2002, UROLOGY, V60, P855, DOI 10.1016/S0090-4295(02)01956-8
  6. Eastham JA, 1996, J UROLOGY, V156, P1707, DOI 10.1016/S0022-5347(01)65488-0
  7. ELBADAWI A, 1974, J UROLOGY, V111, P613
  8. Ficarra V, 2007, EUR UROL, V51, P45, DOI 10.1016/j.eururo.2006.06.017
  9. Ficarra V, 2009, EUR UROL, V55, P1037, DOI 10.1016/j.eururo.2009.01.036
  10. Goluboff ET, 1998, J UROLOGY, V159, P1276, DOI 10.1016/S0022-5347(01)63580-8
  11. JONLER M, 1996, UROLOGY, V48, P430
  12. Kubler HR, 2007, J UROLOGY, V178, P488, DOI 10.1016/j.juro.2007.03.100
  13. Kundu SD, 2004, J UROLOGY, V172, P2227, DOI 10.1097/01.ju.0000145222.94455.73
  14. Lee DJ, 2010, CAN J UROL, V17, P5200
  15. Liss MA, 2010, J UROLOGY, V183, P1464, DOI 10.1016/j.juro.2009.12.009
  16. Marien TP, 2008, BJU INT, V102, P1581, DOI 10.1111/j.1464-410X.2008.07921.x
  17. Nelson CP, 2003, J UROLOGY, V169, P2225, DOI 10.1097/01.ju.0000058213.15524.90
  18. Noguchi M, 2008, BJU INT, V102, P958, DOI 10.1111/j.1464-410X.2008.07759.x
  19. Novara G, 2010, J UROLOGY, V184, P1028, DOI 10.1016/j.juro.2010.04.069
  20. Patel VR, 2009, EUR UROL, V56, P472, DOI 10.1016/j.eururo.2009.06.007
  21. Patel VR, 2005, J UROLOGY, V174, P269, DOI 10.1097/01.ju.0000162082.12962.40
  22. PICK DL, 2011, BJU INT
  23. Rocco F, 2006, J UROLOGY, V175, P2201, DOI 10.1016/S0022-5347(06)00262-X
  24. Rodriguez E, 2006, UROLOGY, V67, P785, DOI 10.1016/j.urology.2005.10.006
  25. Sandhu Jaspreet S, 2010, Curr Urol Rep, V11, P191, DOI 10.1007/s11934-010-0108-6
  26. Stanford JL, 2000, JAMA-J AM MED ASSOC, V283, P354, DOI 10.1001/jama.283.3.354
  27. van der Poel HG, 2009, EUR UROL, V55, P892, DOI 10.1016/j.eururo.2009.01.021
  28. Wei JT, 2000, UROLOGY, V56, P899, DOI 10.1016/S0090-4295(00)00858-X

Coleções
Artigos e Materiais de Revistas Científicas - HC/ICESP