title: Early recovery of urinary continence after radical prostatectomy: correlation with vesico-urethral anastomosis location in the pelvic cavity measured by postoperative cystography.
abstract: OBJECTIVE
  To determine the association of vesico-urethral anastomosis location (VUAL) with early recovery of urinary continence (UC) after radical prostatectomy (RP).
  
  
  METHODS
  A retrospective analysis of 678 patients who underwent RP was carried out. Patients were divided into three groups based on the VUAL as determined by postoperative cystography: group I - VUAL above the upper margin of the symphysis pubis (SP), group II - between the upper margin and the middle of the SP, and group III - below the middle of the SP. Early recovery of UC was defined as using no pads or an occasional security pad within 3 months. Recovery rates were compared between the groups and factors predicting an early recovery of UC were investigated.
  
  
  RESULTS
  Among all patients, 62.2% achieved an early recovery of UC. Patients in group I were younger, with a longer membranous urethra, greater percent of nerve sparing and shorter time to continence than those in groups II or III. Early recovery rates were 89.5%, 69.8% and 40.7% in group I, II and III, respectively (P < 0.001). VUAL remained an independent predictor of early recovery of UC (OR 3.2 for group I vs II and 10.8 for group I vs III [P < 0.001]) when adjusted for age, operative time, membranous urethral length and operation by surgeon with high surgical volume.
  
  
  CONCLUSIONS
  VUAL represents an independent predictor of recovery of UC after RP. A higher VUAL is associated with a higher rate of early recovery of UC.
authors: Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Seong Jin
authors: SJ
authors: Jeong
authors: Junseok
authors: J
authors: Yi
authors: Min Soo
authors: MS
authors: Chung
authors: Dae Sung
authors: DS
authors: Kim
authors: Won Ki
authors: WK
authors: Lee
authors: Hongzoo
authors: H
authors: Park
authors: Cheol Yong
authors: CY
authors: Yoon
authors: Sung Kyu
authors: SK
authors: Hong
authors: Seok-Soo
authors: SS
authors: Byun
authors: Sang Eun
authors: SE
authors: Lee
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods; D012189:Retrospective Studies; D014549:Urinary Incontinence / Q000000981:diagnostic imaging / Q000209:etiology / Q000534:rehabilitation*; D014567:Urography