title: Factors predicting continence recovery 1 month after radical prostatectomy: results of a multicenter survey.
abstract: OBJECTIVE
  To assess the factors associated with continence recovery 1 month after radical prostatectomy (RP) and to identify the correlation between these factors.
  
  
  METHODS
  In total, 2408 men treated with RP for prostate cancer (PCa) were enrolled in the present multicenter prospective study. Clinical (age, body mass index) and urological (catheterization or transurethral resection of the prostate) records, quality of life (QOL) scores determined using various instruments (including the International Index of Erectile Function [IIEF] and University of California Los Angeles, Prostate Cancer Index [UCLA-PCI]), PCa characteristics (clinical stage [cT], prostate-specific antigen, biopsy Gleason score), surgical features (surgical approach, nerve and bladder neck sparing, catheterization), and pathologic outcomes (pT, pN+, Gleason score, positive surgical margins) were recorded. Continence status prior to surgery and at 1 month after RP was assessed and classified as followed: (i) full continence; (ii) 0-1 pads/day; or (iii) >1 pad/day. Only patients determined to have full continence prior to surgery were included in the analysis. Data were evaluated using Spearman's correlation analysis and multivariate logistic regression.
  
  
  RESULTS
  Data from 1972 patients with full continence preoperatively and complete postoperative data were analyzed. At 1 month after RP, 644 patients (32.7%) were fully continent, 810 (41.1%) were using 0-1 pads/day, and 518 (26.3%) were using >1 pad/day. Univariate analysis indicated that clinical and urological data, QOL, PCa characteristics, surgical features, and pathologic outcomes were determinants for continence recovery. Multivariate analysis indicated that preoperative sexual activity (UCLA-PCI Sexual Function P = 0.005; IIEF P = 0.040), bladder neck sparing (P = 0.003), catheterization time (P = 0.007), and catheter diameter (P = 0.046) were associated with 1 month continence recovery.
  
  
  CONCLUSIONS
  Age and nerve sparing are not significant predictors of continence recovery 1 month after RP. Preoperative erectile function can predict post-prostatectomy incontinence. Bladder neck preservation has a significant effect on early continence recovery after RP.
authors.affiliation: Department of Urology, University of Florence, Careggi Hospital, Florence, Italy. maurogacci@yahoo.it
authors.forename: Mauro
authors.initials: M
authors.lastname: Gacci
authors.forename: Marco
authors.initials: M
authors.lastname: Carini
authors.forename: Alchiede
authors.initials: A
authors.lastname: Simonato
authors.forename: Ciro
authors.initials: C
authors.lastname: Imbimbo
authors.forename: Paolo
authors.initials: P
authors.lastname: Gontero
authors.forename: Alberto
authors.initials: A
authors.lastname: Briganti
authors.forename: Ottavio
authors.initials: O
authors.lastname: De Cobelli
authors.forename: Vittorio
authors.initials: V
authors.lastname: Fulcoli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Martorana
authors.forename: Giulio
authors.initials: G
authors.lastname: Nicita
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Mirone
authors.forename: Giorgio
authors.initials: G
authors.lastname: Carmignani
mesh_terms: D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011468:Prostatectomy; D020127:Recovery of Function; D013997:Time Factors; D014549:Urinary Incontinence / Q000517:prevention & control*