title: Predictors of short-term recovery of urinary continence after radical prostatectomy.
abstract: OBJECTIVE
  To evaluate treatment variables for early urinary continence status 6 weeks following radical prostatectomy.
  
  
  METHODS
  In this retrospective analysis, 4,028 consecutive patients underwent open radical retropubic (RRP) or robot-assisted transperitoneal prostatectomy (RARP) at a single academic institution (07/2003-07/2013). After discharge, patients were offered 3-week treatment in a rehabilitation facility. Patients who opted for rehabilitation (n = 2,998, 74.4%) represent our study cohort. Exclusion criteria were acute urinary retention after catheter removal (n = 55, 1.4%), incomplete datasets (n = 50, 1.2%) or refusal of rehabilitation (n = 925, 23.0%). Results of urinary continence were evaluated from final rehabilitation reports. Twenty-two clinical and oncological variables were statistically analysed in uni- and multivariable analyses to determine whether they were associated with early urinary continence status six weeks after radical prostatectomy. Odds ratios and 95% CI as well as p values were calculated. A p level of 0.05 was considered as significant.
  
  
  RESULTS
  Six weeks after surgery, 1,962 (65.4%) patients were continent (≤1 pad/day) and 1,036 (34.6%) patients were considered incontinent. Age, clinical stage, PSA, ASA score, prior TURP, seminal vesicle invasion, Gleason score, nerve-sparing status, intraoperative blood loss, catheterisation time, OR time, surgical caseload >1,000 and the surgeon were associated with continence status on univariable analysis (p < 0.05). On multivariable analysis, nerve-sparing procedure (NS), clinical stage, individual surgeon, patient age, surgical procedure (RARP vs. RRP) and duration of catheterisation were independent predictors (p < 0.05) of incontinence status.
  
  
  CONCLUSIONS
  Strategies that can ensure NS procedures and early catheter removal should be applied to enable early recovery of urinary continence.
authors.affiliation: Department of Urology, Marienhospital Herne, Ruhr-University Bochum, Widumer Strasse 8, 44627, Herne, Germany, Rein-jueri.palisaar@marienhospital-herne.de.
authors.forename: Jüri R
authors.initials: JR
authors.lastname: Palisaar
authors.forename: Florian
authors.initials: F
authors.lastname: Roghmann
authors.forename: Marko
authors.initials: M
authors.lastname: Brock
authors.forename: Björn
authors.initials: B
authors.lastname: Löppenberg
authors.forename: Joachim
authors.initials: J
authors.lastname: Noldus
authors.forename: Christian
authors.initials: C
authors.lastname: von Bodman
mesh_terms: D000368:Aged; D001676:Biofeedback, Psychology; D015331:Cohort Studies; D004599:Electric Stimulation Therapy; D006801:Humans; D010535:Laparoscopy; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D016017:Odds Ratio; D059351:Organ Sparing Treatments; D017773:Pelvic Floor; D026741:Physical Therapy Modalities; D011468:Prostatectomy / Q000379:methods / Q000534:rehabilitation*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D065287:Robotic Surgical Procedures / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome; D014546:Urinary Catheterization / Q000706:statistics & numerical data; D014550:Urinary Incontinence, Stress / Q000534:rehabilitation*