Urinary continence in high-risk prostate cancer after robot-assisted radical prostatectomy

Curr Opin Urol. 2023 Nov 1;33(6):482-487. doi: 10.1097/MOU.0000000000001127. Epub 2023 Aug 30.

Abstract

Purpose of review: Urinary incontinence is common postoperative complication following robot-assisted radical prostatectomy (RARP) in patients with prostate cancer (PCa). Despite the increasing adoption of RARP in the treatment of high-risk PCa (HRPC), concerns persist regarding the adequacy of reported continence outcomes in this subgroup. This review aims to illuminate the state of continence recovery in HRPC patients post-RARP.

Recent findings: Urinary continence (UC) recovery rates in HRPC was reported to be lower than the intermediate/low-risk counterparts from 6 to 24 months post-RARP. Predictive models showed that age, obesity, race, disease status, and surgical approaches represent predictors of continence recovery. Special techniques like NeuroSAFE technique and Retzius-Sparing approach also play a role in reducing incontinence also in the high-risk scenario.

Summary: RARP for HRPC appears to be associated with worse continence compared with other risk groups. A multimodality approach for prediction and prevention of incontinence after RARP is vital. Further research into this area is necessary to enhance continence recovery outcomes in HRPC patients undergoing RARP.

Publication types

  • Review

MeSH terms

  • Humans
  • Male
  • Prostate
  • Prostatectomy / adverse effects
  • Prostatectomy / methods
  • Prostatic Neoplasms* / etiology
  • Recovery of Function
  • Robotic Surgical Procedures* / adverse effects
  • Robotic Surgical Procedures* / methods
  • Robotics*
  • Treatment Outcome
  • Urinary Incontinence* / epidemiology
  • Urinary Incontinence* / etiology
  • Urinary Incontinence* / prevention & control