Author:
Di Bello Francesco,Morra Simone,Fraia Agostino,Pezone Gabriele,Polverino Federico,Granata Giuliano,Collà Ruvolo Claudia,Napolitano Luigi,Ponsiglione Andrea,Stanzione Arnaldo,La Rocca Roberto,Balsamo Raffaele,Creta Massimiliano,Imbriaco Massimo,Imbimbo Ciro,Longo Nicola,Califano Gianluigi
Abstract
AbstractTo test the impact of the prostate-gland asymmetry on continence rates, namely 3- and 12-month continence recovery, in prostate cancer (PCa) patients who underwent robot-assisted radical prostatectomy (RARP). Within our institutional database, RARP patients with complete preoperative MRI features and 12 months follow-up were enrolled (2021–2023). The population has been stratified according to the presence or absence of prostate-gland asymmetry (defined as the presence of median lobe or side lobe dominance). Multivariable logistic regression models (LRMs) predicting the continence rate at 3 and 12 months after RARP were fitted in the overall population. Subsequently, the LRMs were repeated in two subgroup analyses based on prostate size (≤ 40 vs > 40 ml). Overall, 248 consecutive RARP patients were included in the analyses. The rate of continence at 3 and 12 months was 69 and 72%, respectively. After multivariable LRM the bladder neck sparing approach (OR 3.15, 95% CI 1.68–6.09, p value < 0.001) and BMI (OR 0.90, 95% CI 0.82–0.97, p = 0.006) were independent predictors of recovery continence at 3 months. The prostate-gland asymmetry independently predicted lower continence rates at 3 (OR 0.33, 95% CI 0.13–0.83, p = 0.02) and 12 months (OR 0.31, 95% CI 0.10–0.90, p = 0.03) in patients with prostate size ≤ 40 ml. The presence of prostate lobe asymmetry negatively affected the recovery of 3- and 12-months continence in prostate glands ≤ 40 mL. These observations should be considered in the preoperative planning and counseling of RARP patients.
Funder
Università degli Studi di Napoli Federico II
Publisher
Springer Science and Business Media LLC
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