Login to Access Video or Poster Abstract: MP93-04
Sources of Funding: none

Introduction

To evaluate the risk factors of acute urinary retention (AUR) following robot-assisted radical prostatectomy (RARP) including the timing of catheter removal, and to study the relationship of urinary retention with early continence outcomes following RARP, which has never been mentioned in the literature before._x000D_

Methods

740 consecutive underwent RARP by 2 experienced surgeons at our institute were reviewed retrospectively from a prospectively-collected database. Multiple factors including age, body mass index (BMI), international prostatic symptom score (IPSS), prostate volume, presence of median lobe, nerve preservation, anastomosis time, and catheter removal time (day 4 vs 7) were evaluated as risk factors for AUR using univariate and multivariate analysis. The relation between AUR and early return of continence (1 and 3 months) post-RARP was also evaluated._x000D_

Results

The incidence of clinically significant vesicourethral anastomotic leak and AUR following catheter removal were 0.9% and 2.2% (17/740), respectively. In men who developed AUR, there was no significant relationship with regards to age, BMI, IPSS, prostatic volume, median lobe presence, nerve preservation or anastomosis time. Moreover, the incidence of AUR was significantly higher (p=0.004) for men with catheter removal at day 4 (4.5% (16/351)) vs day 7 (0.2% (1/289)). Moreover, patients with early removal of catheter (day 4) whom developed AUR had earlier 1 month return of 0-pad continence 87.5% (14/16) compared to patients without AUR 45.6% (153/335), with no significant deference at 3 months._x000D_

Conclusions

While AUR is an uncommon complication of RARP, its incidence is much higher than VUA leakage and often not discussed during patient counseling. Early catheter removal at day 4 post RARP is associated with higher incidence of AUR. Moreover, men experiencing AUR were observed to have a much earlier return of urinary continence. Future studies are warranted to validate the impact of AUR on long term outcome of continence. _x000D_ _x000D_ _x000D_

Funding

none