Pelvic magnetic resonance imaging parameters predict urinary incontinence after robot-assisted radical prostatectomy

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Abstract

Objective: Urinary incontinence (UI) is a major prostate cancer (PCa) treatment-related morbidity. It has been reported that post-prostatectomy UI is related to the width of the pelvic floor muscles (PFM) and the length of the urethra. However, the details of these anatomical parameters are unknown. The aim of this study was to investigate whether preoperative pelvic parameters or anatomical parameters of the urethra, as measured by magnetic resonance imaging (MRI), are correlated with UI. Methods: Between 2010 and 2017, 571 patients with localized PCa underwent robot-assisted radical prostatectomy (RARP) at Okayama University Hospital. Patients treated by a single experienced surgeon were included in the study. Preoperative prostate volume, obturator internal muscle, anal sphincter muscle, levator ani muscle (LAM), urethra wall thickness (UWT), and membranous urethral length (MUL) were measured by MRI. Patients were divided into two groups depending on leakage status 1 year after RARP using Expanded Prostate Index Composite Item 1. Results: Seventy patients were included in this retrospective study. Based on leakage status, 37 and 33 patients were allocated to the no-leakage and leakage groups, respectively. There were significant differences between the two groups in age (P = 0.03), MUL (P < 0.001), UWT (P = 0.03), and LAM (P = 0.001). Multivariate logistic regression analyses revealed that MUL and LAM predicted UI 1 year after RARP. Conclusions: Pelvic parameters measured by MRI before RARP may be useful in the prediction of UI. In particular, MUL and LAM can predict postoperative UI by strict definition.

Original languageEnglish
JournalLUTS: Lower Urinary Tract Symptoms
DOIs
Publication statusAccepted/In press - Jan 1 2018

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Urinary Incontinence
Prostatectomy
Anal Canal
Magnetic Resonance Imaging
Muscles
Urethra
Prostate
Prostatic Neoplasms
Pelvic Floor
Retrospective Studies
Age Groups
Logistic Models
Regression Analysis
Morbidity

Keywords

  • computer-assisted surgery
  • incontinence
  • magnetic resonance imaging (MRI)
  • prostate cancer
  • prostatectomy

ASJC Scopus subject areas

  • Neurology
  • Urology

Cite this

@article{8b6b88ecb8e14b37b81c3e22dc6f92d2,
title = "Pelvic magnetic resonance imaging parameters predict urinary incontinence after robot-assisted radical prostatectomy",
abstract = "Objective: Urinary incontinence (UI) is a major prostate cancer (PCa) treatment-related morbidity. It has been reported that post-prostatectomy UI is related to the width of the pelvic floor muscles (PFM) and the length of the urethra. However, the details of these anatomical parameters are unknown. The aim of this study was to investigate whether preoperative pelvic parameters or anatomical parameters of the urethra, as measured by magnetic resonance imaging (MRI), are correlated with UI. Methods: Between 2010 and 2017, 571 patients with localized PCa underwent robot-assisted radical prostatectomy (RARP) at Okayama University Hospital. Patients treated by a single experienced surgeon were included in the study. Preoperative prostate volume, obturator internal muscle, anal sphincter muscle, levator ani muscle (LAM), urethra wall thickness (UWT), and membranous urethral length (MUL) were measured by MRI. Patients were divided into two groups depending on leakage status 1 year after RARP using Expanded Prostate Index Composite Item 1. Results: Seventy patients were included in this retrospective study. Based on leakage status, 37 and 33 patients were allocated to the no-leakage and leakage groups, respectively. There were significant differences between the two groups in age (P = 0.03), MUL (P < 0.001), UWT (P = 0.03), and LAM (P = 0.001). Multivariate logistic regression analyses revealed that MUL and LAM predicted UI 1 year after RARP. Conclusions: Pelvic parameters measured by MRI before RARP may be useful in the prediction of UI. In particular, MUL and LAM can predict postoperative UI by strict definition.",
keywords = "computer-assisted surgery, incontinence, magnetic resonance imaging (MRI), prostate cancer, prostatectomy",
author = "Takuya Sadahira and Yosuke Mitsui and Motoo Araki and Yuki Maruyama and Koichiro Wada and Kohei Edamura and Yasuyuki Kobayashi and Masami Watanabe and Toyohiko Watanabe and Yasutomo Nasu",
year = "2018",
month = "1",
day = "1",
doi = "10.1111/luts.12245",
language = "English",
journal = "LUTS: Lower Urinary Tract Symptoms",
issn = "1757-5664",
publisher = "Wiley Blackwell",

}

TY - JOUR

T1 - Pelvic magnetic resonance imaging parameters predict urinary incontinence after robot-assisted radical prostatectomy

AU - Sadahira, Takuya

AU - Mitsui, Yosuke

AU - Araki, Motoo

AU - Maruyama, Yuki

AU - Wada, Koichiro

AU - Edamura, Kohei

AU - Kobayashi, Yasuyuki

AU - Watanabe, Masami

AU - Watanabe, Toyohiko

AU - Nasu, Yasutomo

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objective: Urinary incontinence (UI) is a major prostate cancer (PCa) treatment-related morbidity. It has been reported that post-prostatectomy UI is related to the width of the pelvic floor muscles (PFM) and the length of the urethra. However, the details of these anatomical parameters are unknown. The aim of this study was to investigate whether preoperative pelvic parameters or anatomical parameters of the urethra, as measured by magnetic resonance imaging (MRI), are correlated with UI. Methods: Between 2010 and 2017, 571 patients with localized PCa underwent robot-assisted radical prostatectomy (RARP) at Okayama University Hospital. Patients treated by a single experienced surgeon were included in the study. Preoperative prostate volume, obturator internal muscle, anal sphincter muscle, levator ani muscle (LAM), urethra wall thickness (UWT), and membranous urethral length (MUL) were measured by MRI. Patients were divided into two groups depending on leakage status 1 year after RARP using Expanded Prostate Index Composite Item 1. Results: Seventy patients were included in this retrospective study. Based on leakage status, 37 and 33 patients were allocated to the no-leakage and leakage groups, respectively. There were significant differences between the two groups in age (P = 0.03), MUL (P < 0.001), UWT (P = 0.03), and LAM (P = 0.001). Multivariate logistic regression analyses revealed that MUL and LAM predicted UI 1 year after RARP. Conclusions: Pelvic parameters measured by MRI before RARP may be useful in the prediction of UI. In particular, MUL and LAM can predict postoperative UI by strict definition.

AB - Objective: Urinary incontinence (UI) is a major prostate cancer (PCa) treatment-related morbidity. It has been reported that post-prostatectomy UI is related to the width of the pelvic floor muscles (PFM) and the length of the urethra. However, the details of these anatomical parameters are unknown. The aim of this study was to investigate whether preoperative pelvic parameters or anatomical parameters of the urethra, as measured by magnetic resonance imaging (MRI), are correlated with UI. Methods: Between 2010 and 2017, 571 patients with localized PCa underwent robot-assisted radical prostatectomy (RARP) at Okayama University Hospital. Patients treated by a single experienced surgeon were included in the study. Preoperative prostate volume, obturator internal muscle, anal sphincter muscle, levator ani muscle (LAM), urethra wall thickness (UWT), and membranous urethral length (MUL) were measured by MRI. Patients were divided into two groups depending on leakage status 1 year after RARP using Expanded Prostate Index Composite Item 1. Results: Seventy patients were included in this retrospective study. Based on leakage status, 37 and 33 patients were allocated to the no-leakage and leakage groups, respectively. There were significant differences between the two groups in age (P = 0.03), MUL (P < 0.001), UWT (P = 0.03), and LAM (P = 0.001). Multivariate logistic regression analyses revealed that MUL and LAM predicted UI 1 year after RARP. Conclusions: Pelvic parameters measured by MRI before RARP may be useful in the prediction of UI. In particular, MUL and LAM can predict postoperative UI by strict definition.

KW - computer-assisted surgery

KW - incontinence

KW - magnetic resonance imaging (MRI)

KW - prostate cancer

KW - prostatectomy

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U2 - 10.1111/luts.12245

DO - 10.1111/luts.12245

M3 - Article

JO - LUTS: Lower Urinary Tract Symptoms

JF - LUTS: Lower Urinary Tract Symptoms

SN - 1757-5664

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