Recovery of urinary function after radical prostatectomy: Predictors of urinary function on preoperative prostate magnetic resonance imaging Journal Article

   

Authors:	Von Bodman, C. ; Matsushita, K.; Savage, C.; Matikainen, M. P.; Eastham, J. A.; Scardino, P. T.; Rabbani, F.; Akin, O.; Sandhu, J. S.
Article Title:	Recovery of urinary function after radical prostatectomy: Predictors of urinary function on preoperative prostate magnetic resonance imaging
Abstract:	Purpose: We determined whether pelvic soft tissue and bony dimensions on endorectal magnetic resonance imaging influence the recovery of continence after radical prostatectomy, and whether adding significant magnetic resonance imaging variables to a statistical model improves the prediction of continence recovery. Materials and Methods: Between 2001 and 2004, 967 men undergoing radical prostatectomy underwent preoperative magnetic resonance imaging. Soft tissue and bony dimensions were retrospectively measured by 2 raters blinded to clinical and pathological data. Patients who received neoadjuvant therapy, who were preoperatively incontinent or had missing followup for continence were excluded from study, leaving 600 patients eligible for analysis. No pad use defined continent. Logistic regression was used to identify variables associated with continence recovery at 6 and 12 months. We evaluated whether the predictive accuracy of a base model was improved by adding independently significant magnetic resonance imaging variables. Results: Urethral length and urethral volume were significantly associated with the recovery of continence at 6 and 12 months. Larger inner and outer levator distances were significantly associated with a decreased probability of regaining continence at 6 or 12 months, but they did not reach statistical significance for other points. Addition of these 4 magnetic resonance imaging variables to a base model including age, clinical stage, prostate specific antigen and comorbidities marginally improved the discrimination (12-month AUC improved from 0.587 to 0.634). Conclusions: Membranous urethral length, urethral volume, and an anatomically close relation between the levator muscle and membranous urethra on preoperative magnetic resonance imaging are independent predictors of continence recovery after radical prostatectomy. The addition of magnetic resonance imaging variables to a base model improved the predictive accuracy for continence recovery, but the predictive accuracy remains low. © 2012 American Urological Association Education and Research, Inc.
Keywords:	aged; major clinical study; disease course; nuclear magnetic resonance imaging; outcome assessment; magnetic resonance imaging; preoperative evaluation; sensitivity analysis; prostate specific antigen; retrospective study; gleason score; prostatic neoplasms; body mass; urine incontinence; prostatectomy; prostate biopsy; comorbidity; convalescence; urinary incontinence; predictive value; urethra function; pelvic girdle; pelvimetry; bone structure; levator ani muscle; membranous urethral length; urethral volume; urogenital system parameters
Journal Title:	Journal of Urology
Volume:	187
Issue:	3
ISSN:	0022-5347
Publisher:	Elsevier Science, Inc.
Date Published:	2012-03-01
Start Page:	945
End Page:	950
Language:	English
DOI:	10.1016/j.juro.2011.10.143
PROVIDER:	scopus
PUBMED:	22264458
PMCID:	PMC4768862
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-84857064105&partnerID=40&md5=21664e65dd9522774a71181c16a367a0
Notes:	--- - "Cited By (since 1996): 1" - "Export Date: 2 April 2012" - "CODEN: JOURA" - "Source: Scopus"

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