Abstract
OBJECTIVE: Radical prostatectomy (RP) is considered the gold standard treatment for patients with localized prostate cancer (PCa). All patients undergoing RP, either open, laparoscopic, or robotic, are at risk of developing urinary incontinence after RP. Our study aimed to analyze possible predictors of early postoperative (within 3 months) urinary continence (UC) outcomes following extraperitoneal single-site robot-assisted RP (ss-RARP) for localized PCa. METHODS: We retrospectively reviewed data from 113 patients with localized PCa who were operated on by a highly experienced surgeon between September 2022 and December 2023. Patient characteristics (age, body mass index, prostate volume, prostate dimensions, preoperative and postoperative membranous urethral length, and percentage of membranous urethra removed) were analyzed using logistic regression to determine the independent factors contributing to short-term UC recovery after extraperitoneal ss-RARP. From the time of urinary catheter removal after surgery, the recovery of UC was followed up every month, and UC was defined as using ≤1 safety pad daily, known as social continence. RESULTS: The proportions of continent patients immediately after urinary catheter removal, 1 month, and 3 months after extraperitoneal ss-RARP were 22%, 49%, and 82%, respectively. The multivariate logistic regression analysis showed that the percentage of membranous urethra removed (p=0.016) and prostate volume (p=0.049) were associated with social UC recovery immediately after urinary catheter removal, and craniocaudal dimension of the prostate (p=0.042) and age (p=0.014) were associated with social UC recovery 1 month and 3 months after extraperitoneal ss-RARP, respectively. CONCLUSION: The percentage of membranous urethra removed, prostate volume, craniocaudal dimension of the prostate, and age are independent risk factors for social UC early after extraperitoneal ss-RARP.