title: Predictors of immediate continence following robot-assisted radical prostatectomy.
abstract: BACKGROUND
  Few studies have examined the patient characteristics that lead to early continence after robot-assisted radical prostatectomy (RARP), and to date, there has been no investigation into the predictors of immediate continence. In the current study, we examine a large multisurgeon population of patients undergoing RARP to assess for predictors of this outcome.
  
  
  METHODS
  Between January 2008 and December 2010, 1270 patients who underwent RARP at our institution, with complete preoperative and follow-up data, were assessed for urinary function prospectively. Univariable and multivariable logistic regressions were used to assess for predictors of zero pad usage after RARP. Patient and operative characteristics examined include age, body-mass index, prostate-specific antigen, adjusted Charlson comorbidity index (CCI), Gleason sum, international prostate symptom score, clinical stage, nerve sparing, bladder neck reconstruction, posterior anastomotic reconstruction, surgeon volume, and percutaneous suprapubic tube (PST) bladder drainage.
  
  
  RESULTS
  Overall, 17.3% of patients (n=219) never required a pad after catheter removal. Characteristics associated with never requiring a pad are age, preoperative Gleason sum, CCI, nerve sparing, prostate weight, surgeon volume, and PST bladder drainage. Independent predictors of never requiring a pad after catheter removal included nerve-sparing (B/L standard as referent) wide dissection [OR: 0.96 (95% CI: 0.49, 1.88)], unilateral inter-/intrafascial [OR: 1.20 (0.70, 2.06)], bilateral inter-/intrafascial [OR: 1.97 (1.36, 2.86)], and PST drainage [OR: 2.53 (1.56, 4.11)].
  
  
  CONCLUSIONS
  In a study reflective of broad RARP practice at our institution, 17.3% of patients were entirely pad free after RARP. The type of nerve sparing performed and placement of a PST for bladder drainage postoperatively were found to be independently predictive of never requiring a pad after RARP.
authors.affiliation: Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI 48202, USA. jsammon79@gmail.com
authors.forename: Jesse D
authors.initials: JD
authors.lastname: Sammon
authors.forename: Pranav
authors.initials: P
authors.lastname: Sharma
authors.forename: Quoc-Dien
authors.initials: QD
authors.lastname: Trinh
authors.forename: Khurshid R
authors.initials: KR
authors.lastname: Ghani
authors.forename: Shyam
authors.initials: S
authors.lastname: Sukumar
authors.forename: Mani
authors.initials: M
authors.lastname: Menon
mesh_terms: D003710:Demography; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011468:Prostatectomy / Q000009:adverse effects*; D012371:Robotics; D014549:Urinary Incontinence / Q000209:etiology*