Relationship between recovery of urinary continence after laparoscopic radical prostatectomy and prostatic volume and intravesical prostatic protursion length / 北京大学学报(医学版)

ABSTRACT

OBJECTIVE@#To assess the relationship between recovery of urinary continence after laparoscopic radical prostatectomy (LRP) and prostatic volume (PV) and intravesical prostatic protrusion length (IPPL) on preoperative magnetic resonance imaging (MRI).@*METHODS@#88 patients with pathologic confirmed prostate carcinoma who were underwent LRP were included in this study. MRI examination was performed in 1 week before the biopsy. The patients were divided into two groups according to PV (<50 mL, ≥50 mL) on preoperative MRI. The patients were divided into two groups according to IPPL (<5 mm, ≥5 mm), IPPL was measured on MRI as the vertical distance from the tip of the protruding prostate to the base of the urinary bladder. After surgery we recorded and analyzed recovery of urinary continence of the patients for one year.@*RESULTS@#All the 88 patients received extra-peritoneal LRP successfully. The average operation time was (155±67) min, and the estimated blood volume was (145±159) mL. There was a significant difference between group PV<50 mL and ≥50 mL in the operation time (P=0.045). All the patients who underwent MRI preoperatively showed that their mean PV was (44.54±26.58) mL and mean IPPL was (5.2±5.7) mm. The continence rate for all the patients after LRP was 53.4%, 84.1% and 94.3% in their follow-up of 3, 6 and 12 months. Three months after LRP, the continence rate for group PV<50 mL and ≥50 mL were 61.5% and 30.4%, which were completely continent (P=0.010). Six or twelve months after surgery, the continence rate was 87.7% and 73.9% (P=0.120), 96.9% and 87.0% (P=0.076) for group PV<50 mL and ≥50 mL separately. Three months after LRP, the continence rate for group IPPL<5 mm and ≥5 mm were 66.1% and 31.3%, which were completely continent (P=0.002). Six months after surgery, the continence rate was 92.6% and 68.8% (P=0.003), and one year after surgery, the continence rate was 98.2% and 87.5% for group IPPL<5 mm and ≥5 mm separately (P=0.037). There was a significant difference between group PV<50 mL and ≥50 mL in the urinary continence curve (P=0.017), and the same significant difference between group IPPL<5 mm and ≥5 mm (P=0.001).@*CONCLUSION@#The PV and IPPL on preoperative MRI were associated with significantly slower return of urinary continence, especially for early recovery (3 months) of continence after LRP.