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Insights into urinary incontinence after robot-assisted radical prostatectomy: urgent urinary incontinence or stress urinary incontinence

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Abstract

Purpose

Urinary incontinence is a common complication following robot-assisted radical prostatectomy (RARP). Few studies have explored the relationships and differences between stress urinary incontinence (SUI) and urgent urinary incontinence (UUI) after RARP. This study aimed to investigate the occurrence rates and risk factors of UUI and SUI in short term after RARP.

Methods

We prospectively included prostate cancer patients who underwent RARP by a single surgeon. Demographics, lower urinary tract function, oncology, and follow-ups were recorded. Occurrence rates and risk factors of UUI and SUI within 3 months after catheter withdrawal were calculated.

Results

The study cohort included 363 subjects with a mean age of 66.05 years. The median preoperative International Prostate Symptom Score (IPSS) was 14 (range 0–35), and the median Overactive Bladder Symptom Score (OABSS) was 3 (range 0–14). The occurrence rate of UUI and SUI at 3 months after catheter withdrawal was 8.5% (31/363) and 15.2% (55/363). Nearly all patients with UUI also had SUI. Diabetes history and high OABSS before RARP were independent risk factors for UUI, especially within 1 month after catheter withdrawal. The Gleason Score was an independent risk factor for SUI at 3 months after catheter withdrawal. Additionally, UUI but not SUI might be an influencing factor for decision-making regarding postoperative radiotherapy.

Conclusion

The occurrence rate of SUI after RARP was persistently higher than that of UUI. Nearly all of the patients with UUI simultaneously had SUI. The risk factors of UUI and SUI after RARP were absolutely different.

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Funding

The study was funded by National key research and development project (Grant no. 2018YFC2002204) and Peking University Medicine Fund of Fostering Young Scholars’ Scientific & Technological Innovation (Grant no. BMU2018PYB002).

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Author notes

  1. Yuke Chen, Han Hao and Silu Chen contribute equally to this manuscript.

  2. Cheng Shen and Shiliang Wu are the two corresponding authors.

Authors and Affiliations

  1. Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, 8 **shiku Street, **cheng District, Bei**g, 100034, China

    Yuke Chen, Han Hao, Silu Chen, Xu Chen, Yue Liu, Meng Zhang, Wei Yu, Cheng Shen & Shiliang Wu

Authors
  1. Yuke Chen
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  2. Han Hao
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  3. Silu Chen
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  4. Xu Chen
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  6. Meng Zhang
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  7. Wei Yu
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  8. Cheng Shen
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Contributions

YKC: project development, data collection, manuscript writing, data analysis. HH: data collection, manuscript writing. SLC: data collection, manuscript writing. XC: data collection, data management. YL: data collection, data management. MZ: data management. WY: project development. CS: project development, data collection, data management. SLW: project development, manuscript editing.

Corresponding authors

Correspondence to Cheng Shen or Shiliang Wu.

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Conflict of interest

There are no competing interests in relation to the work.

Ethical approval

The study was approved by the Ethics Committee of Peking University First Hospital (No. 2020 [278]). The study was performed in accordance with the Declaration of Helsinki.

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Informed consent was obtained from all individual participants included in the study.

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Chen, Y., Hao, H., Chen, S. et al. Insights into urinary incontinence after robot-assisted radical prostatectomy: urgent urinary incontinence or stress urinary incontinence. World J Urol 41, 3635–3642 (2023). https://doi.org/10.1007/s00345-023-04584-9

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  • DOI: https://doi.org/10.1007/s00345-023-04584-9

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