Nerve-Sparing Surgery Significantly Affects Long-Term Continence After Radical Prostatectomy

• Published in: Urology (Ridgewood, N.J.) N.J.), 2007-12, Vol.70 (6), p.1127-1130
• Main Authors: Nandipati, Kalyana C, Raina, Rupesh, Agarwal, Ashok, Zippe, Craig D
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Follow-Up Studies; Humans; Male; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Prostatectomy - adverse effects; Prostatectomy - methods; Prostatic Neoplasms - surgery; Urethra - innervation; Urinary Incontinence - etiology; Urinary Incontinence - prevention & control; Urology
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2007.07.042

Objectives In this long-term prospective study we evaluated the factors affecting urinary continence after radical prostatectomy. Methods In this study, we recruited 156 patients (mean age, 64.1 ± 6.7 years; follow-up, 7.8 ± 1.3 years; prostate-specific antigen [PSA] level, 9.57 ± 8.81 ng/mL) who underwent radical prostatectomy between 1995 and 1998. Long-term data were obtained on 152 patients, with 4 patients lost to follow-up. Incontinence was evaluated by the number of pads per day. Follow-up data were collected at 3, 6, 12, and 24 months and annually. The multivariate analysis included the following variables: preoperative PSA levels, nerve-sparing (NS) status (bilateral NS, unilateral NS, and non-NS), and age at the time of operation (≤65 or >65 years). Results With a mean follow-up of 7.8 ± 1.3 years, the overall incontinence rate was 17.7% (27 of 152). The incontinence rates were significantly higher in the non-NS group (18 of 61) compared with the bilateral NS group (6 of 66; P 0.05 ) . When stratified by the NS status, the bilateral NS group had a significant improvement in overall continence. The association between age and incontinence was significant: P