title: Factors Contributing to Early Recovery of Urinary Continence Analyzed by Pre- and Postoperative Pelvic Anatomical Features at Robot-Assisted Laparoscopic Radical Prostatectomy.
abstract: OBJECTIVE
  The aim of the present study is to elucidate factors contributing to early recovery of urinary continence after robot-assisted laparoscopic radical prostatectomy (RARP) from the perspective of urethral and vesical anatomical features after RARP.
  
  
  METHODS
  Sixty consecutive patients undergoing RARP also underwent pre- and postoperative urethrovesicography (UVG). Both pre- and postoperative UVG evaluated the posterior-urethral vesical angle and position of the urethrovesical junction. Postoperative UVG was performed 7 days after RARP and also evaluated postoperative membranous urethral length (MUL) and the postoperative degree of atony of the external urethral sphincter. Associations were analyzed between pre- or postoperative UVG variables and urinary incontinence as well as between UVG variables significantly correlating with urinary incontinence and neurovascular bundle-preservation procedures.
  
  
  RESULTS
  Postoperative MUL was the only factor significantly associated with the state of continence in the early postoperative period according to multivariate logistic regression analysis (odds ratio, 1.94; 95% confidence interval, 1.22-3.12; p<0.005). A cutoff value of 17 mm offered the best accuracy in receiver operating characteristics analysis. Postoperative MUL was significantly increased in the group with preservation of the neurovascular bundle (p=0.01).
  
  
  CONCLUSIONS
  Postoperative MUL is the most important factor for recovery of urinary continence in the early postoperative period after RARP. Postoperative MUL >17 mm as measured on UVG can be expected to predict early recovery of urinary continence. Postoperative MUL was greater with preservation of the neurovascular bundle, thus allowing early recovery of urinary continence.
authors.affiliation: 1 Department of Urology, School of Medicine, Fukushima Medical University , Fukushima, Japan .
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Haga
authors.affiliation: 1 Department of Urology, School of Medicine, Fukushima Medical University , Fukushima, Japan .
authors.forename: Soichiro
authors.initials: S
authors.lastname: Ogawa
authors.affiliation: 1 Department of Urology, School of Medicine, Fukushima Medical University , Fukushima, Japan .
authors.forename: Michihiro
authors.initials: M
authors.lastname: Yabe
authors.affiliation: 1 Department of Urology, School of Medicine, Fukushima Medical University , Fukushima, Japan .
authors.forename: Hidenori
authors.initials: H
authors.lastname: Akaihata
authors.affiliation: 1 Department of Urology, School of Medicine, Fukushima Medical University , Fukushima, Japan .
authors.forename: Junya
authors.initials: J
authors.lastname: Hata
authors.affiliation: 1 Department of Urology, School of Medicine, Fukushima Medical University , Fukushima, Japan .
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Sato
authors.affiliation: 1 Department of Urology, School of Medicine, Fukushima Medical University , Fukushima, Japan .
authors.forename: Kei
authors.initials: K
authors.lastname: Ishibashi
authors.affiliation: 2 Department of Radiology, School of Medicine, Fukushima Medical University , Fukushima, Japan .
authors.forename: Osamu
authors.initials: O
authors.lastname: Hasegawa
authors.affiliation: 2 Department of Radiology, School of Medicine, Fukushima Medical University , Fukushima, Japan .
authors.forename: Ken
authors.initials: K
authors.lastname: Kikuchi
authors.affiliation: 2 Department of Radiology, School of Medicine, Fukushima Medical University , Fukushima, Japan .
authors.forename: Fumio
authors.initials: F
authors.lastname: Shishido
authors.affiliation: 1 Department of Urology, School of Medicine, Fukushima Medical University , Fukushima, Japan .
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kojima
mesh_terms: D000368:Aged; D015331:Cohort Studies; D006801:Humans; D007564:Japan; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008297:Male; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D010388:Pelvis / Q000473:pathology; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control; D011184:Postoperative Period; D057234:Preoperative Period; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods; D012372:ROC Curve; D020127:Recovery of Function; D012371:Robotics / Q000379:methods*; D014521:Urethra / Q000473:pathology*; D014549:Urinary Incontinence / Q000209:etiology* / Q000517:prevention & control