MP63-19 CORRELATION BETWEEN PELVIC LYMPH NODE DISSECTION AND URINARY INCONTINENCE AFTER ROBOT ASSISTED RADICAL PROSTATECTOMY

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Non-neurogenic Voiding Dysfunction II (MP63)1 Sep 2021MP63-19 CORRELATION BETWEEN PELVIC LYMPH NODE DISSECTION AND URINARY INCONTINENCE AFTER ROBOT ASSISTED RADICAL PROSTATECTOMY Ken Lee, Masaki Shiota, Dai Takamatsu, Miho Ushijima, Keisuke Monji, Eiji Kashiwagi, Ario Takeuchi, Junichi Inokuchi, and Masatoshi Eto Ken LeeKen Lee More articles by this author , Masaki ShiotaMasaki Shiota More articles by this author , Dai TakamatsuDai Takamatsu More articles by this author , Miho UshijimaMiho Ushijima More articles by this author , Keisuke MonjiKeisuke Monji More articles by this author , Eiji KashiwagiEiji Kashiwagi More articles by this author , Ario TakeuchiArio Takeuchi More articles by this author , Junichi InokuchiJunichi Inokuchi More articles by this author , and Masatoshi EtoMasatoshi Eto More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002103.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To investigate the correlation between extended pelvic lymph node dissection (ePLND) and urinary incontinence (UI) after robot-assisted laparoscopic radical prostatectomy (RALP). METHODS: This study was approved by the institutional ethical committee of Kyushu University. Patients were diagnosed by histopathology as adenocarcinoma of the prostate. ePLND was performed in patients with high-risk prostate cancer based on NCCN, D’Amico classification and Japan PC table criteria. In the present study, patients who underwent either ipsilateral or bilateral nerve sparing during surgery were excluded. The number of pad (more than two pad per day was recognized as significant UI) as well as international prostate symptom score (IPSS) were evaluated before and 1, 3, 6 and 12 months after RALP between both groups. RESULTS: Between April 2014 and June 2019, total of 366 patients received RALP at Kyushu University. 170 cases underwent RALP without ePLND (LN-), while 196 with ePLND (LN+). Patients with LN+ had significantly higher PSA level, clinical stage and Gleason score in comparison with LN-, whilst age, BMI, duration of indwelling catheter and urethrovesical anastomosis time were not changed between both groups. Univariate and multivariate analysis indicated significant correlation of UI with LN+ cases (p=0.04, 0.03) and prostate volume (p=0.02, p=0.01, respectively). Ratio of significant UI at 1 month after RALP was increased in LN+ (75.2 %) compared with LN- group (65.4 %, p=0.04). On the other hand, UI was decreased at 3 (43.2 in LN+ vs 36.5% in LN-), 6 (25.6 vs 23.8 %), 12 months (15.7 vs 18.6 %) and had no significant difference in two groups. IPSS score was greater in 1 month LN+ (14.6±0.5) than LN- group (13.3±0.6) followed by a decrease of IPSS score at 3 (10.1±0.4 in LN+ vs 9.4±0.5 in LN-), 6 (8.2±0.4 vs 8.6±0.5), 12 months (7.6±0.5, 8.0±0.5) after RALP without any statistical difference. CONCLUSIONS: Increased UI as well as IPSS score at one month in ePLND cases suggest neural denervation might be caused during PLND. Further examination is needed to confirm such hypothesis, however, these data may be one of supportive tools that inform patients who receive ePLND for prostate cancer surgery of a risk of UI. Source of Funding: This research was supported by Grant-in-Aid to KL (20K22956) © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1109-e1109 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ken Lee More articles by this author Masaki Shiota More articles by this author Dai Takamatsu More articles by this author Miho Ushijima More articles by this author Keisuke Monji More articles by this author Eiji Kashiwagi More articles by this author Ario Takeuchi More articles by this author Junichi Inokuchi More articles by this author Masatoshi Eto More articles by this author Expand All Advertisement PDF downloadLoading ...