title: Impact of prostatic apical shape and protrusion on early recovery of continence after robot-assisted radical prostatectomy.
abstract: OBJECTIVE
  To investigate the impact of prostatic apical shape from preoperative magnetic resonance imaging on early recovery of urinary continence after robot-assisted radical prostatectomy (RARP).
  
  
  METHODS
  We reviewed the records of 1011 patients who underwent RARP at a tertiary center from October 2007 to March 2013. Patients were stratified into 4 different groups by prostatic apical shapes as shown on preoperative magnetic resonance imaging (groups A-D). The early recovery of urinary continence was defined as 0 or 1 security pad/d within 12 weeks after the surgery. The association between early recovery of continence and various factors was analyzed.
  
  
  RESULTS
  Overall, 807 patients (79.8%) showed early recovery of urinary continence. The numbers of patients in groups A, B, C, and D were 88 (8.7%), 478 (47.3%), 167 (16.5%), and 278 (27.5%), respectively. There were no significant differences in the rates of early recovery of urinary continence between different groups (P = .257). On multivariate analysis, the patient's age (odds ratio [OR], 0.960; P = .004), preoperative International Index of Erectile Function-5 score (OR, 1.029; P = .009), neurovascular bundle preservation (OR, 1.586; P = .013), and membranous urethral length (OR, 1.104; P = .001) were revealed as independent prognostic factors in the early recovery of urinary continence.
  
  
  CONCLUSIONS
  The results of our study showed that the prostatic apical shape does not influence the early recovery of urinary continence. We believe this is another strong point of RARP compared with conventional open surgery, particularly for patients with complex type of apical shape.
authors.affiliation: Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Hakmin
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Kwangmo
authors.initials: K
authors.lastname: Kim
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Sung Il
authors.initials: SI
authors.lastname: Hwang
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Hak Jong
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Seok-Soo
authors.initials: SS
authors.lastname: Byun
authors.affiliation: Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Sang Eun
authors.initials: SE
authors.lastname: Lee
authors.affiliation: Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea. Electronic address: skhong@snubh.org.
authors.forename: Sung Kyu
authors.initials: SK
authors.lastname: Hong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000473:pathology* / Q000601:surgery*; D011468:Prostatectomy / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D013997:Time Factors; D014554:Urination