Internal anal sphincter activity is associated with stress urinary incontinence after radical prostatectomy
Ju-Chuan Hu (1,2,3), Kun-Yuan Chiu (1), Shian-shiang Wang (1,3), Chia-yen Lin (1,3), Jian-ri Li (1,3,4)
(1) Taichung Veterans General Hospital, Taichung, Taiwan, (2) Su-Ao Branch, Taipei Veterans General Hospital, Yilan, Taiwan, (3) Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, (4) Department of Medicine and Nursing, Hung Kuang University, Taichung, Taiwan
Stress urinary incontinence (SUI) is a common post-operative complication afterradical prostatectomy (RP). Several surgical techniques such as Retriuz sparing orbladder neck suspension were reported beneficial in the early recovery of SUI. Wereported our observational study in the association between internal anal sphincteractivity and post-RP SUI.
Between April 2018 and March 2019, 63 patients received laparoscopic or robotic RPwere included in this observational series. General oncologic characteristics, internalanal sphincter power and coordination, and SUI severity by post-operative 1 month,3 months, and 6 months were recorded. Association analysis between clinicalparameters with SUI was performed.
The median age of whole patient cohorts was 67 years. 30 (48.4%) patients hadpathology T3 diseases. 33 (52.4%) patients had positive apex margin involvementand 11(17.7%) had bladder neck or seminal vesicle invasion. Immediate continencewas recorded in 3 patients. The percentage of 0 pad use in post-op 1 month, 3months and 6 months were 17.7%, 73.4% and 83.4% respectively. The internal analsphincter power scale were recorded full score in 47.2%, 83.4% and 89.1%respectively during post-op 1 month, 3 months and 6 months follow-up as well as36.3%, 68.1% and 92.4% respectively in the internal anal sphincter coordinationscale full score records. For multivariate analysis, Retriuz sparing surgery, internalanal sphincter power and coordination were associated with post-op one month SUI(p=0.001, 0.007, 0.009 respectively) but not in post-op 6 months.
Retriiuz sparing surgery and internal anal sphincter muscle power and coordinationcould act as an indicator for post-RP one month SUI.