title: Predictive factors for immediate continence after radical prostatectomy.
abstract: OBJECTIVE
  To identify predictive factors for immediate continence after radical prostatectomy.
  
  
  METHODS
  A total of 1553 patients underwent radical prostatectomy in a single institution (670 RRP, 883 RARP), had complete perioperative data and follow-up for urinary continence and were included in this prospective analysis. Immediate continence was defined as no pad usage after catheter removal. Evaluated parameters included age, body mass index, ECOG performance status, erectile function, prostate volume, PSA, Gleason score, tumor stage and D'Amico risk groups, as well as surgical approach (RRP, RARP), surgeon volume, nerve-sparing, lymphadenectomy, blood transfusions and duration of catheterization.
  
  
  RESULTS
  A total of 240 men (15.5 %) did not require any pads 1 day or later after removal of the transurethral catheter. Correlation of parameters with immediate continence revealed significance for age (p < 0.001), ECOG-score (p = 0.025), erectile function (p = 0.001), nerve-sparing (p = 0.022), Gleason score (p = 0.002) and surgeon volume (p ≤ 0.022). Multivariate analyses identified IIEF-score >21 (p = 0.031), ECOG (p < 0.05), bilateral nerve-sparing (p = 0.049), Gleason score <3 + 4 (p ≤ 0.028), less blood transfusion (p ≤ 0.044) and surgeon volume (p ≤ 0.042) as the remaining prognostic parameters for immediate continence after radical prostatectomy. The type of surgical approach (robotic vs. open radical prostatectomy) did not yield significant influence.
  
  
  CONCLUSIONS
  Evaluating continence in a contemporary prospective cohort revealed 15.5 % of patients never requiring a pad postoperatively. Predictive parameters for immediate continence were erectile function, ECOG, bilateral nerve-sparing, less blood transfusion and Gleason score. Furthermore, the surgeon's experience but not his operative technique had a significant impact on immediate postoperative continence.
authors.affiliation: Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany. gencay.hatiboglu@med.uni-heidelberg.de.
authors.forename: G
authors.initials: G
authors.lastname: Hatiboglu
authors.affiliation: Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Teber
authors.affiliation: Department of Biostatistics, DKFZ Heidelberg, Im Neuenheimer Feld 581, 69120, Heidelberg, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Tichy
authors.affiliation: Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Pahernik
authors.affiliation: Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Hadaschik
authors.affiliation: Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Nyarangi-Dix
authors.affiliation: Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Hohenfellner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion / Q000706:statistics & numerical data; D015331:Cohort Studies; D003661:Decision Support Techniques; D007172:Erectile Dysfunction / Q000453:epidemiology; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D010388:Pelvis; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000601:surgery*; D020127:Recovery of Function; D065287:Robotic Surgical Procedures; D013997:Time Factors; D014546:Urinary Catheterization / Q000706:statistics & numerical data; D014549:Urinary Incontinence / Q000453:epidemiology*
keywords: Immediate continence; Prognostic factors; Prostatectomy