Predictors of prolonged severe urinary incontinence after robot-assisted radical prostatectomy: a prospective study.

Objective: To identify predictors of prolonged severe urinary incontinence after robot-assisted radical prostatectomy (RARP), perioperative clinical parameters were investigated.

Methods: Participants were 299 patients who underwent RARP at our institute.　Prolonged severe urinary incontinence was defined as a 1-h (one-hour) pad test >50 g/h and/or use of >3 pads/day at 12 months after RARP.　The cohort was divided into severe and non-severe urinary incontinence groups according to this criterion.　Perioperative clinical parameters were compared between groups to identify predictors for prolonged severe urinary incontinence after RARP.

Results: Twenty-seven patients (9.0%) were categorized into the severe urinary incontinence group.　The remaining 272 patients (91.0%) were categorized into the non-severe urinary incontinence group.　Univariate analysis revealed prolonged severe urinary incontinence as significantly associated with older age (P=0.011), high BMI (P=0.001), lymph node dissection (P=0.003), non-preservation of nerves (P=0.039), non-preservation of fascia of the levator ani muscle (P=0.009), and high risk in the D'Amico risk classification (P=0.010).　Multivariate analysis revealed prolonged severe urinary incontinence as significantly correlated with high BMI (P=0.009) and high risk in the D'Amico risk classification (P=0.007).

Conclusions: High BMI and D'Amico high-risk status are associated with prolonged severe urinary incontinence after RARP.