Journal of Yeungnam Medical Science

Original article

Novel cystography parameter to predict early recovery from urinary continence after radical prostatectomy for prostate cancer: a retrospective study: Yeong Uk Kim; J Yeungnam Med Sci. 2023;40(3):252-258. Published online July 21, 2022; DOI: https://doi.org/10.12701/jyms.2022.00311

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Background
The purpose of this study was to investigate whether postoperative cystography findings can predict early and long-term recovery from incontinence after radical prostatectomy (RP), compared with the other cystography parameters.
Methods
I retrospectively reviewed 118 patients who underwent robot-assisted RP (RARP) for localized prostate cancer at single institution between January 2016 and April 2021. One hundred and seven patients were included in the study. Postoperative cystography was routinely performed 7 days after surgery. The bladder neck to pubic symphysis ratio, vesicourethral angle, and bladder neck anteroposterior length (BNAP) ratio (the bladder neck-posterior margin distances divided by the anteroposterior lengths) were evaluated. Continence was defined as cessation of pad use. The association between these variables and urinary incontinence was also analyzed.
Results
The urinary incontinence recovery rates 1, 3, 6, and 12 months after RARP were 43.92%, 66.35%, 87.85%, and 97.19%, respectively. Multivariate logistic regression analysis demonstrated that a lower BNAP ratio and wider vesicourethral angle were significantly associated with continence restoration at 1, 3, and 6 months after surgery. In addition, in terms of days of pad usage, lower BNAP ratio, wider vesicourethral angle, and bladder neck preservation were significantly associated with recovery from urinary incontinence within 12 months as assessed by Cox proportional hazard analysis.
Conclusion
This study demonstrated that vesicourethral angle and BNAP ratio were independent predictors of early recovery from post-prostatectomy incontinence. I suggest that both the sagittal and coronal views of postoperative cystography help anticipate early continence restoration after RARP.

Citations

Citations to this article as recorded by

A single‐center retrospective comparative analysis of urinary continence in robotic prostatectomy with a combination of umbilical ligament preservation and Hood technique
Hiroaki Shimmura, Taro Banno, Kazutaka Nakamura, Anju Murayama, Haruki Shigeta, Toyoaki Sawano, Yukiko Kouchi, Akihiko Ozaki, Fumito Yamabe, Junpei Iizuka, Toshio Takagi
International Journal of Urology.2023; 30(10): 889. CrossRef

Original Article

Effectiveness of the Transrectal Ultrasonography in the Detection of Prostate Cancer: in Patients with Prostate Specific Antigen of 10 ng/ml or Less.: Han Won Chang, Jae Ho Cho; Yeungnam Univ J Med. 2004;21(2):191-197. Published online December 31, 2004; DOI: https://doi.org/10.12701/yujm.2004.21.2.191

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Abstract PDF: BACKGROUND
This study was performed to reconsider the efficacy of transrectal ultrasonography (TRUS) in diagnosing prostate cancer by analyzing the results of a digital rectal examination (DRE), serum prostate-specific antigen (PSA) and a transrectal ultrasono- graphy in patients with prostate specific antigen levels of 10 ng/ml or less. MATERIALS AND METHODS: One-hundred and eighty one men with PSA levels of 10 ng/ml or less, who had a TRUS-guided tissue biopsy performed, were included in this study. The detection rate of prostate cancer was compared according to the TRUS result and the presence or absence of nodularity and the consistency of the prostate on DRE. RESULTS: In a total 181 patients, there were 73 patients with PSA levels of 4 ng/ml or less and 4 of them had prostate cancer. Thre were 108 patients with PSA levels of 4-10 ng/ml and 18 of them were prostate cancer. TRUS was performed in 152 patients and 16 out of 58 patients diagnosed with prostate cancer, 3 out of 39 diagnosed with suspicious prostate cancer, and 2 out of 55 patients diagnosed as having no prostate cancer were found to have prostate cancer. In 40 patients, a nodule was palpated on DRE and 8 of them were found to have prostate cancer. Five out of 19 patients with a stony hard consistency, 3 of 12 with a firm to hard consisency, 12 of 129 with a firm consistency, 0 of 13 with a soft to firm consistency, and 2 of 8 with a soft consistency were prostate cancer. In the prostate cancer patients, there were 4 patients with PSA levels of 4 ng/ml or less and all these patients were diagnosed with prostate cancer or suspicious prostate cancer on TRUS but the nodule was not palpated in all patients. Two were soft and 2 were firm consistency on DRE. CONCLUSION: In patients with serum PSA levels of 10 ng/ml or less, TRUS is a more useful supporting method than DRE and a more active application of TRUS may lead to an early diagnosis and pertinent treatment of prostate cancer.

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