Abstract: PD39-12
Sources of Funding: This study was supported by Award Number 8157101445 from National Natural Science Foundation of China.

Introduction

To investigate and summarize clinical presentations and characteristics of post-prostatectomy incontinence (PPI), and to analyze the relationship between patients’ clinicopathological features and PPI incidence, severity and recovery as well.

Methods

Clinical and pathological data of 364 patients who underwent radical prostatectomy in Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine between February 2013 and February 2015 were prospectively collected, including 7 lifestyle and comorbidity factors (age, BMI, smoking, etc.), 11 preoperative clinical factors (prostate volume, biopsy approaches, preoperative lower urinary symptoms, etc.), surgeon and surgical method, 4 postoperative clinical factors (complications, postoperative PSA, etc.) and 9 pathological factors (pT, pN, Gleason score, etc.). The incidence, severity and recovery of PPI was followed up by phone call and email. Logistic regression analysis and Cochran’s and Mantel-Haenszel Chi-square test were used to analyze the relationship between all the features and PPI incidence and severity, respectively. A Kaplan-Meier curve was created to clarify recovery of incontinence after prostatectomy. Cox regression analysis was performed in the analysis of influence factors of PPI recovery. Nomograms were formulated based on the results of multivariate analysis and by using the package of rms in R version 2.14.1.

Results

All 364 patients had complete data and the medium follow-up time was 17 months. The total immediate incontinence rate was 61.8%. The incontinence rate was 10.4% at the 12th month after the surgery. Risk factors related to PPI incidence included smoking, hypertension, preoperative incontinence, preoperative dysuresia and chief surgeon. Risk factors related to PPI severity included age, preoperative PSA, neutrophil-to-lymphocyte ratio, postoperative urinary stricture and Gleason score. Risk factors related to PPI recovery included age, BMI, diabetes, hernia, biopsy approaches, prostate volume, preoperative incontinence, preoperative dysuresia, preoperative PSA, postoperative urinary stricture and PPI severity. Age, BMI and PPI severity were independent predictor of PPI recovery.

Conclusions

Incontinence is a very common complication after radical prostatectomy, which adversely affects patients’ quality of life. According to the nomograms developed by this study, now it is possible to predict the incidence of PPI and PPI recovery probabilities, which offers a strong evidence to the establishment of personalized prostate cancer management.

Funding

This study was supported by Award Number 8157101445 from National Natural Science Foundation of China.