title: Comprehensive prediction model of urinary incontinence one year following robot-assisted radical prostatectomy.
abstract: OBJECTIVE
  Urinary incontinence (UI) still remains one of the major functional complications after robot-assisted radical prostatectomy (RARP). As the cause for UI is multifactorial, it is quite difficult to make a prediction preoperatively. Considering intraoperative and postoperative risk factors, besides the preoperative ones, we designed an incontinence prediction model, administered 1 month after the surgery, in order to identify incontinent patients at 1 year.
  
  
  METHODS
  We retrospectively reviewed 244 patients who underwent RARP at our institution. Only 209 patients had sufficient data, a 1-year follow-up and were continent preoperatively. The association of UI with the risk factors was assessed by univariable and multivariable regression models.
  
  
  RESULTS
  There was a 17.2% global UI rate at 1 year after RARP. Only age-adjusted Charlson comorbidity index, erectile function assessed by International Index of Erectile Function-5, prostate volume, nerve-sparing status and 24-hour urine loss at 1 month correlated with UI (p = 0.032, 0.009, 0.031, 0.018 and <0.001, respectively). The accuracy of the prediction model of UI was 92.8% (c-index), with an area under the curve of 91.9%.
  
  
  CONCLUSIONS
  Age-adjusted Charlson comorbidity index, International Index of Erectile Function-5, prostate volume, nerve-sparing status and 24-hour urine loss at 1 month after RARP can predict an individual's risk of UI at 1 year after RARP with good accuracy. Further external validation is required in order to generalize the use of this model.
authors.affiliation: Carlos Haya Hospital, Malaga, Spain. barnoiu @ yahoo.com
authors.forename: Ovidiu-Spiru
authors.initials: OS
authors.lastname: Barnoiu
authors.forename: Francisco
authors.initials: F
authors.lastname: Baron Lopez
authors.forename: Emilio
authors.initials: E
authors.lastname: Garcia Galisteo
authors.forename: Jorge
authors.initials: J
authors.lastname: Soler Martinez
authors.forename: Raul
authors.initials: R
authors.lastname: Vozmediano Chicharro
authors.forename: Jose Maria
authors.initials: JM
authors.lastname: Del Rosal Samaniego
authors.forename: Javier
authors.initials: J
authors.lastname: Machuca Santacruz
authors.forename: Pablo
authors.initials: P
authors.lastname: Navarro Vilchez
authors.forename: Javier
authors.initials: J
authors.lastname: Sanchez Luque
authors.forename: Carlos
authors.initials: C
authors.lastname: Bautista Vidal
authors.forename: Pablo
authors.initials: P
authors.lastname: Gomez Lechuga
authors.forename: Victor
authors.initials: V
authors.lastname: Baena Gonzalez
mesh_terms: D000367:Age Factors; D019540:Area Under Curve; D015897:Comorbidity; D003661:Decision Support Techniques; D007172:Erectile Dysfunction / Q000209:etiology; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D049451:Nomograms; D018579:Patient Selection; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012371:Robotics; D013997:Time Factors; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology*