PD19-04 USING PELVIC ANATOMY AS A PREDICTOR OF EARLY CONTINENCE AFTER EXTRAPERITONEAL SINGLE-PORT ROBOTIC RADICAL PROSTATECTOMY

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy II (PD19)1 Sep 2021PD19-04 USING PELVIC ANATOMY AS A PREDICTOR OF EARLY CONTINENCE AFTER EXTRAPERITONEAL SINGLE-PORT ROBOTIC RADICAL PROSTATECTOMY Sij Hemal, Alireza Aminsharifi, Pedram Aram, Alp Tuna Beksac, Mahmoud Abou Zeinab, and Jihad Kaouk Sij HemalSij Hemal More articles by this author , Alireza AminsharifiAlireza Aminsharifi More articles by this author , Pedram AramPedram Aram More articles by this author , Alp Tuna BeksacAlp Tuna Beksac More articles by this author , Mahmoud Abou ZeinabMahmoud Abou Zeinab More articles by this author , and Jihad KaoukJihad Kaouk More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002008.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We assessed the value of pelvic cavity index (PCI), an objective pelvimetry measure, to predict operative time, margin status and return of urinary continence after extraperitoneal single-port robotic radical prostatectomy (RP). We sought to define an optimal cutoff value for PCI, which would optimize functional and oncologic outcomes. METHODS: 94 patients underwent extraperitoneal single-port robotic RP and had preoperative cross-sectional imaging. After measuring anatomical characteristics on preoperative imaging, PCI was calculated as (Pelvic Inlet Diameter x Pelvic Outlet Diameter)/Pelvic Depth. The predictive value of PCI on operative time, surgical margin status and 3-month urinary continence recovery was assessed using regression models. Receiver-Operating Characteristic (ROC) Analysis was performed to evaluate the optimal cutoff value of PCI for predicting continence recovery. RESULTS: Mean operative time was 193.8±36.2 minutes and a positive surgical margin was detected in 25/94 (26.6%) of final pathology specimens. 3-month and 6-month postoperative continence rates were 60/87 (69%) and 71/80 (88.8%), respectively. Prostate weight was significantly associated with a longer operative time (odds ratio [OR]: 3.21 95% confidence interval [CI] 1.4–4.84; p=0.017). No significant associations were noted between clinical characteristics (including PCI) and operative time. Similarly, other than pathological stage, no clinical variables (including PCI) were predictive of a positive surgical margin. A higher PCI was associated with significantly higher rates of continence at 3 months after surgery (OR 2.44 (1.75–5.33); p= 0.01). On ROC- analysis, a PCI cutoff value of 8.21 cm yielded the best accuracy (AUC= 0.733, 95% CI 0.615–0.851; p=0.001). Interestingly, no association was noted between the analyzed variables and 6-month continence rate. Table (a) CONCLUSIONS: PCI may not be associated with operative time or positive surgical margin status after extraperitoneal single-port robotic RP in experienced hands. However, a higher PCI is associated with a higher rate of early continence following surgery. PCI value at a cutoff of 8.2 cm has optimal efficacy in predicting postoperative urine continence recovery. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e362-e363 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sij Hemal More articles by this author Alireza Aminsharifi More articles by this author Pedram Aram More articles by this author Alp Tuna Beksac More articles by this author Mahmoud Abou Zeinab More articles by this author Jihad Kaouk More articles by this author Expand All Advertisement PDF downloadLoading ...