Effect of prostatic apex shape (Lee types) and urethral sphincter length in preoperative MRI on very early continence rates after radical prostatectomy.
Aged
Anatomic Variation
Humans
Male
Middle Aged
Multiparametric Magnetic Resonance Imaging
Organ Size
Postoperative Complications
/ epidemiology
Preoperative Period
Prostate
/ anatomy & histology
Prostatectomy
/ methods
Prostatic Neoplasms
/ surgery
Retrospective Studies
Time Factors
Urethra
/ anatomy & histology
Urinary Incontinence
/ epidemiology
Lee type, functional outcome
ORP
PAD-test
RARP
Journal
International urology and nephrology
ISSN: 1573-2584
Titre abrégé: Int Urol Nephrol
Pays: Netherlands
ID NLM: 0262521
Informations de publication
Date de publication:
Jul 2021
Jul 2021
Historique:
received:
27
11
2020
accepted:
08
02
2021
pubmed:
20
2
2021
medline:
27
11
2021
entrez:
19
2
2021
Statut:
ppublish
Résumé
To test the effect of anatomic variants of the prostatic apex overlapping the membranous urethra (Lee type classification), as well as median urethral sphincter length (USL) in preoperative multiparametric magnetic resonance imaging (mpMRI) on the very early continence in open (ORP) and robotic-assisted radical prostatectomy (RARP) patients. In 128 consecutive patients (01/2018-12/2019), USL and the prostatic apex classified according to Lee types A-D in mpMRI prior to ORP or RARP were retrospectively analyzed. Uni- and multivariable logistic regression models were used to identify anatomic characteristics for very early continence rates, defined as urine loss of ≤ 1 g in the PAD-test. Of 128 patients with mpMRI prior to surgery, 76 (59.4%) underwent RARP vs. 52 (40.6%) ORP. In total, median USL was 15, 15 and 10 mm in the sagittal, coronal and axial dimensions. After stratification according to very early continence in the PAD-test (≤ 1 g vs. > 1 g), continent patients had significantly more frequently Lee type D (71.4 vs. 54.4%) and C (14.3 vs. 7.6%, p = 0.03). In multivariable logistic regression models, the sagittal median USL (odds ratio [OR] 1.03) and Lee type C (OR: 7.0) and D (OR: 4.9) were independent predictors for achieving very early continence in the PAD-test. Patients' individual anatomical characteristics in mpMRI prior to radical prostatectomy can be used to predict very early continence. Lee type C and D suggest being the most favorable anatomical characteristics. Moreover, longer sagittal median USL in mpMRI seems to improve very early continence rates.
Identifiants
pubmed: 33606155
doi: 10.1007/s11255-021-02809-7
pii: 10.1007/s11255-021-02809-7
pmc: PMC8192356
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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