Preoperative predictive model of recovery of urinary continence after radical prostatectomy Journal Article

Authors: Matsushita, K.; Kent, M. T.; Vickers, A. J.; Von Bodman, C.; Bernstein, M.; Touijer, K. A.; Coleman, J. A.; Laudone, V. T.; Scardino, P. T.; Eastham, J. A.; Akin, O.; Sandhu, J. S.
Article Title: Preoperative predictive model of recovery of urinary continence after radical prostatectomy
Abstract: Objective To build a predictive model of urinary continence recovery after radical prostatectomy (RP) that incorporates magnetic resonance imaging (MRI) parameters and clinical data. Patients and Methods We conducted a retrospective review of data from 2 849 patients who underwent pelvic staging MRI before RP from November 2001 to June 2010. We used logistic regression to evaluate the association between each MRI variable and continence at 6 or 12 months, adjusting for age, body mass index (BMI) and American Society of Anesthesiologists (ASA) score, and then used multivariable logistic regression to create our model. A nomogram was constructed using the multivariable logistic regression models. Results In all, 68% (1 742/2 559) and 82% (2 205/2 689) regained function at 6 and 12 months, respectively. In the base model, age, BMI and ASA score were significant predictors of continence at 6 or 12 months on univariate analysis (P < 0.005). Among the preoperative MRI measurements, membranous urethral length, which showed great significance, was incorporated into the base model to create the full model. For continence recovery at 6 months, the addition of membranous urethral length increased the area under the curve (AUC) to 0.664 for the validation set, an increase of 0.064 over the base model. For continence recovery at 12 months, the AUC was 0.674, an increase of 0.085 over the base model. Conclusion Using our model, the likelihood of continence recovery increases with membranous urethral length and decreases with age, BMI and ASA score. This model could be used for patient counselling and for the identification of patients at high risk for urinary incontinence in whom to study changes in operative technique that improve urinary function after RP. © 2015 The Authors © 2015 BJU International Published by John Wiley & Sons Ltd.
Keywords: adult; controlled study; aged; major clinical study; validation process; nuclear magnetic resonance imaging; outcome assessment; magnetic resonance imaging; preoperative evaluation; retrospective study; prediction; high risk patient; age; prostatic neoplasms; body mass; total quality management; urine incontinence; prostatectomy; scoring system; convalescence; urinary incontinence; nomogram; patient counseling; urinary tract function; membranous urethral length; urogenital system parameters; human; male; priority journal; article; american society of anesthesiologist score
Journal Title: BJU International
Volume: 116
Issue: 4
ISSN: 1464-4096
Publisher: Wiley Blackwell  
Date Published: 2015-10-01
Start Page: 577
End Page: 583
Language: English
DOI: 10.1111/bju.13087
PROVIDER: scopus
PUBMED: 25682782
PMCID: PMC4768861
Notes: Export Date: 2 October 2015 -- Source: Scopus
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MSK Authors
  1. Jaspreet Sandhu
    98 Sandhu
  2. Jonathan Coleman
    184 Coleman
  3. Vincent Laudone
    59 Laudone
  4. Peter T Scardino
    621 Scardino
  5. Abdelkrim Karim Touijer
    190 Touijer
  6. Andrew J Vickers
    556 Vickers
  7. James Eastham
    426 Eastham
  8. Oguz Akin
    177 Akin
  9. Matthew T Kent
    26 Kent