MP18-12: Preoperative MRI Anatomical Predictors of Early Continence after Single-Port Transvesical Robot-Assisted Radical Prostatectomy
Friday, May 3, 2024 3:30 PM to 5:30 PM · 2 hr. (US/Central)
302B
Abstract
Information
Full Abstract and Figures
Author Block
Roxana Ramos*, Prasad R Shankar, Nicolas Soputro, Adriana M Pedraza, Jaya S Chavali, Carter Mikesell, Jennifer Bullen, Ryan Ward, Andrei Purysko, Jihad Kaouk, Cleveland, OH
Introduction
Previous studies have associated anatomical factors to continence following radical prostatectomy, with a longer membranous urethral length (MUL) being the most common predictor. Since 2021, one of the reported benefits of single-port (SP) transvesical (TV) robot-assisted radical prostatectomy (RARP) has been a short time to continence, with a median of 3 to 7 days. Our objective is to identify preoperative anatomical predictors associated with an early return to continence after SP TV RARP.
Methods
Retrospective single-center cohort study of SP TV RARP cases from January 2022 to March 2023 with preoperative multiparametric magnetic resonance imaging (MP-MRI). Two urogenital radiologists independently reviewed the images and assessed 10 anatomical parameters (Fig. 1) to determine their ability to distinguish men who achieved urinary continence within 1 week and 3 months of SP TV RARP from those who did not. For each MRI parameter and clinical outcome, we used nonparametric methods to estimate the receiver operating characteristic (ROC) curve and its area (AUC) for each reader. Intraclass correlation coefficient (ICC) was used to quantify inter-reader agreement. All analyses were performed in R version 4.3.0.
Results
A total of 44 cases were reviewed. Fifteen men (34%) achieved urinary continence within one week, while 29 (67%) achieved continence within 3 months. In this interim analysis, MUL was the only parameter that showed a significant association with early return to continence (Fig. 2). The AUC for coronal MUL at the one-week time point was 0.68 (95% CI: 0.53, 0.83). Inter-reader agreement was moderate for all measured variables (ICC range 0.42-0.82).
Conclusions
In this interim analysis, MUL was the only preoperative anatomical factor significantly associated with continence within a week and three months after SP TV RARP. Postoperative MRI comparison studies are needed to assess the uniqueness of the SP TV RARP technique in sparing periprostatic structures to facilitate an early return to continence.
Source Of Funding
None
Author Block
Roxana Ramos*, Prasad R Shankar, Nicolas Soputro, Adriana M Pedraza, Jaya S Chavali, Carter Mikesell, Jennifer Bullen, Ryan Ward, Andrei Purysko, Jihad Kaouk, Cleveland, OH
Introduction
Previous studies have associated anatomical factors to continence following radical prostatectomy, with a longer membranous urethral length (MUL) being the most common predictor. Since 2021, one of the reported benefits of single-port (SP) transvesical (TV) robot-assisted radical prostatectomy (RARP) has been a short time to continence, with a median of 3 to 7 days. Our objective is to identify preoperative anatomical predictors associated with an early return to continence after SP TV RARP.
Methods
Retrospective single-center cohort study of SP TV RARP cases from January 2022 to March 2023 with preoperative multiparametric magnetic resonance imaging (MP-MRI). Two urogenital radiologists independently reviewed the images and assessed 10 anatomical parameters (Fig. 1) to determine their ability to distinguish men who achieved urinary continence within 1 week and 3 months of SP TV RARP from those who did not. For each MRI parameter and clinical outcome, we used nonparametric methods to estimate the receiver operating characteristic (ROC) curve and its area (AUC) for each reader. Intraclass correlation coefficient (ICC) was used to quantify inter-reader agreement. All analyses were performed in R version 4.3.0.
Results
A total of 44 cases were reviewed. Fifteen men (34%) achieved urinary continence within one week, while 29 (67%) achieved continence within 3 months. In this interim analysis, MUL was the only parameter that showed a significant association with early return to continence (Fig. 2). The AUC for coronal MUL at the one-week time point was 0.68 (95% CI: 0.53, 0.83). Inter-reader agreement was moderate for all measured variables (ICC range 0.42-0.82).
Conclusions
In this interim analysis, MUL was the only preoperative anatomical factor significantly associated with continence within a week and three months after SP TV RARP. Postoperative MRI comparison studies are needed to assess the uniqueness of the SP TV RARP technique in sparing periprostatic structures to facilitate an early return to continence.
Source Of Funding
None
Sessions
MP18: Imaging/Uroradiology I
302B