CLINICAL AND MORPHOLOGICAL PREDICTORS OF PERSISTENT URINARY INCONTINENCE AFTER RADICAL PROSTATECTOMY
Keywords:
prostate cancer, radical prostatectomy, urinary incontinence, post-prostatectomy incontinence, risk factors, predictors, pad-testAbstract
Objective. To identify clinical and morphological predictors of persistent urinary incontinence after radical prostatectomy based on the analysis of urological and oncological risk factors. Materials and Methods. A single-center retrospective study included 501 patients who underwent radical prostatectomy for prostate cancer. The primary endpoint was clinically significant urinary incontinence 12 months after surgery. Multivariate logistic regression analysis was used to identify independent predictors. Results. Adverse pathological tumor characteristics were associated with a higher incidence of persistent urinary incontinence. Independent predictors of clinically significant urinary incontinence at 12 months were age ≥70 years (OR=1.7; 95% CI 1.2–2.4), pT3–4 stage (OR=1.5; 95% CI 1.1–2.1), pN1 status (OR=1.5; 95% CI 1.0–2.2), and severe early postoperative urinary incontinence with pad-test >18 g (OR=3.8; 95% CI 2.3–6.0). Early postoperative urinary incontinence demonstrated the highest prognostic value. Conclusions. Persistent urinary incontinence after radical prostatectomy is determined by the combined influence of clinical and pathological factors. Age ≥70 years, pT3–4 stage, pN1 status, and pad-test >18 g are significant predictors of unfavorable functional outcomes.
References
Gacci M., De Nunzio C., Sakalis V., Rieken M., Cornu J.N., Gravas S. Latest Evidence on Post-Prostatectomy Urinary Incontinence. Journal of Clinical Medicine. 2023;12(3):1190.
Breyer B.N., Kim S.K., Kirkby E. et al. Updates to Incontinence After Prostate Treatment: AUA/GURS/SUFU Guideline. Journal of Urology. 2024;212(4):531–538.
Yu S. et al. Prediction of early urinary continence after radical prostatectomy. Frontiers in Oncology. 2025.
Yamashita K., Kijima Y., Sekido E., Nagasaka N., Inui M. Predictors of Long-Term Urinary Incontinence After Robot-Assisted Laparoscopic Prostatectomy. Research and Reports in Urology. 2023;15:387–393.
Shen C. et al. Nomogram predicting early urinary incontinence after radical prostatectomy. BMC Cancer. 2024;24:1095.
Bhatt N.R. et al. Post-prostatectomy incontinence: a guideline of guidelines. BJU International. 2024;133(5):513–523.
Sandhu J.S. et al. Incontinence after Prostate Treatment: AUA/SUFU Guideline. Journal of Urology. 2019;202(2):369–378.
Alimjanovich , R. Z., Maxammatkulovich , R. N., & Khikmatovich , K. K. (2022). Age Features of the Prevalence of Prostate Cancer in Uzbekistan. Central Asian Journal of Medical and Natural Science, 3(5), 154-157. Retrieved from https://cajmns.centralasianstudies.org/index.php/CAJMNS/article/view/1062
Rizaev Jasur , Rakhimov Nodir , Kodyrov Khamidullo , Shakhanova Shakhnoza . Study of prostate cancer death by regions of the republic of Uzbekistan.Journal of Biomedicine and Practice. 2022, vol . 7, issue 5, pp.202-210
Rizaev AND . A. , Rakhimov N. M. , Kadirov X . X . RESPUBLIK A NING VILOYATL A R KESIMID A PROST A T A BEZI S A R A TONINI K A S A LL A NISH KO'RS A TGICHINI O'RG A NISH // MAGAZINE REPRODUCTIVE HEALTH AND URO - NEPHROLOGICAL RESEARCH . – 2022. – T. 3. – No. 3.
