PD43-08 DISPLACEMENT OF THE URETHRA AND MEMBRANOUS URETHRAL VOLUME INCREASES THE RISK OF INCONTINENCE AT 3 MONTHS FOLLOWING RADICAL PROSTATECTOMY

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy II (PD43)1 Apr 2020PD43-08 DISPLACEMENT OF THE URETHRA AND MEMBRANOUS URETHRAL VOLUME INCREASES THE RISK OF INCONTINENCE AT 3 MONTHS FOLLOWING RADICAL PROSTATECTOMY Ha Hong Koo, Sean Mungovan*, Petra L. Graham, Henk B. Luiting, Ja Joon Ku, Chan Ho Lee, Ho Kyung Seo Goyang, Jaspreet S. Sandhu, Oguz Akin, and Manish I. Patel Ha Hong KooHa Hong Koo More articles by this author , Sean Mungovan*Sean Mungovan* More articles by this author , Petra L. GrahamPetra L. Graham More articles by this author , Henk B. LuitingHenk B. Luiting More articles by this author , Ja Joon KuJa Joon Ku More articles by this author , Chan Ho LeeChan Ho Lee More articles by this author , Ho Kyung Seo GoyangHo Kyung Seo Goyang More articles by this author , Jaspreet S. SandhuJaspreet S. Sandhu More articles by this author , Oguz AkinOguz Akin More articles by this author , and Manish I. PatelManish I. Patel More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000930.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Incontinence after radical prostatectomy is poorly understood. Preoperative factors such as age and membranous urethral length (MUL) have been shown to correlate with postoperative continence but the true mechanism is not known. We aim to determine whether pelvic soft tissue structures on magnetic resonance imaging (MRI) influence the recovery of continence 3 months after radical prostatectomy. METHODS: Between 2010 and 2013, 246 men undergoing radical prostatectomy underwent preoperative and 3 month postoperative MRI. In total 86 soft-tissue and boney dimensions were retrospectively measured by 2 raters blinded to clinical and pathological data. No pad use defined continent patients.Paired-t tests and two-sample t-tests were used to compare dependent and independent groups, respectively. RESULTS: Membranous urethral length increases significantly from an average of 13.6mm to 15.7mm postoperatively (p<0.001). Continent patients had significantly longer MUL pre- and postoperatively than incontinent patients (p<0.010). Continent patients had significantly larger membranous urethral volume postoperatively (MUV, p=0.025). MUL volume increased by 784mm3in incontinent and by 1823mm3in continent patients at 3 months postoperatively, respectively. This difference was not significant (p=0.139). Incontinent patients had significantly larger proximal displacement of the proximal membranous urethra (PMU) on average than continent patients (p=0.008). Table 1: Difference between continent and incontinent patients at 3 months CONCLUSIONS: MUL increases significantly following RP, indicating that lengthening of the MUL occurs early after surgery. The postoperative MUL and volume are important predictors of postoperative incontinence. Loss of MUV not length is not an important predictor of incontinence at 3 months. Proximal displacement of the PMU can occur with traction and is also associated with postoperative incontinence. Source of Funding: Nil © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e903-e903 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ha Hong Koo More articles by this author Sean Mungovan* More articles by this author Petra L. Graham More articles by this author Henk B. Luiting More articles by this author Ja Joon Ku More articles by this author Chan Ho Lee More articles by this author Ho Kyung Seo Goyang More articles by this author Jaspreet S. Sandhu More articles by this author Oguz Akin More articles by this author Manish I. Patel More articles by this author Expand All Advertisement PDF downloadLoading ...