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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Surg. | doi: 10.3389/fsurg.2019.00060

Very early continence after radical prostatectomy and its influencing factors

 Lena Theissen1*, Felix Chun2, Frederik Roos2, Andreas Becker2,  Luis A. Kluth2,  Severine Banek2, Felix Preisser2,  Mike Wenzel2,  Clara Humke2, Boris Bodelle3, Jens Köllermann4* and  Philipp Mandel2
  • 1University Hospital Frankfurt, Germany
  • 2Department of Urology, University Hospital Frankfurt, Germany
  • 3Department of radiology, University Hospital Frankfurt, Frankfurt am Main, Germany, Germany
  • 4Senckenberg Institute for Pathology, University Hospital Frankfurt, Germany

Introduction & objectives: Surgical techniques such as preservation of the full functional-length of the urethral sphincter (FFLU) have a positive impact on postoperative continence rates. Thereby, data on very early continence rates after radical prostatectomy (RP) are scarce. The aim of the present study was to analyze very early continence rates in patients undergoing FFLU during RP.
Materials & methods: Very early-continence was assessed by using the PAD-test within 24 hours after removal of the transurethral catheter. The PAD-test is a validated test that measures the amount of involuntary urine loss while performing predefined physical activities within 1h (e.g. coughing, walking, climbing stairs). Full continence was defined as a urine loss below 1g. Mild, moderate and severe incontinence was defined as urine loss of 1-10g, 11-50g and >50g, respectively.
Results: 90 patients were prospectively analyzed. Removal of the catheter was performed on the 6th postoperative day. Proportions for no, mild, moderate and severe incontinence were 18.9, 45.5, 20.0 and 15.6%, respectively. In logistic regression younger age was associated with significant better continence (HR 2.52, p=0.04), while bilateral nerve-sparing (HR 2.56, p=0.057) and organ-confined tumor (HR 2.22, p=0.078) showed lower urine loss, although the effect was statistically not significant. In MVA, similar results were recorded.
Conclusion: Overall, 64.4% of patients were continent or suffered only from mild incontinence at 24h after catheter removal. In general, reduced urine loss was recorded in younger patients, patients with organ-confined tumor and in patients with bilateral nerve sparing. Severe incontinence rates were remarkably low with 15.6%.

Keywords: Radical prostatecomy, FFLU, Catheter removal, Early continence, prostate 
cancer, Prostate - surgery

Received: 03 Sep 2019; Accepted: 07 Oct 2019.

Copyright: © 2019 Theissen, Chun, Roos, Becker, Kluth, Banek, Preisser, Wenzel, Humke, Bodelle, Köllermann and Mandel. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Mx. Lena Theissen, University Hospital Frankfurt, Frankfurt, Germany, lena-theissen@web.de
Dr. Jens Köllermann, Senckenberg Institute for Pathology, University Hospital Frankfurt, Frankfurt, 60596, Hesse, Germany, Jens.koellermann@kgu.de