Novel uroflow stop test at time of catheter removal is a strong predictor of early urinary continence recovery following robotic-assisted radical prostatectomy: A pilot study

Authors


  • All authors disclose no conflict of interest and no funding sources.
  • Robert Pickard led the peer-review process as the Associate Editor responsible for the paper.

ABSTRACT

Aim

  • To study whether the ability to completely stop urinary flow during voiding at time of catheter removal, measured objectively using uroflowmetry, can predict early recovery of urine continence following robotic-assisted radical prostatectomy (RARP).

Materials and Methods

  • In this pilot study, 108 patients with a minimum of 2 years follow-up, operated by a single surgeon (AEH) were subjected to an uroflowmetry at the time of urethral catheter removal following RARP.
  • Normal Saline (150 ml) was instilled intravesically prior to catheter removal and patients were instructed to attempt to stop urine flow during voiding in uroflowmeter.
  • Two groups were studied, group one with positive Stop Test (n = 80) and group two with negative Stop Test (n = 28).
  • Covariates included age, BMI, IPSS score, PSA, tumor stage, prostate volume, nerve sparing status, and estimated blood loss.

Results

  • Basic characteristics were not statistically different between both groups.
  • Early continence recovery was significantly higher in group one.
  • Pad-free continence rates in group one and two at 1, 3, 6, 12, 18, and 24 months were 62% vs. 7% (P < 0.001), 85% vs. 28% (P < 0.001), 93% vs. 67% (P 0.001), 93% vs. 82% (P 0.079), 97% vs. 82% (P 0.006), and 97% vs. 85% (P 0.023), respectively.
  • Uroflow Stop Test was the only independent predictor of early urine continence recovery on univariate and multivariate regression analysis [OR 2.87 (95%CI 1.34–4.38, P = < 0.001)].

Conclusion

  • Novel use of uroflowmetry at time of urethral catheter removal is a simple, non-invasive study with independent ability to predict early continence recovery following RARP. Neurourol. Urodynam. 34:60–64, 2015. © 2013 Wiley Periodicals, Inc.

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