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Review
. 2024 Nov 11;13(22):6780.
doi: 10.3390/jcm13226780.

Factors Contributing to Early Recovery of Urinary Continence Following Radical Prostatectomy: A Narrative Review

Bara Barakat  1   2 , Boris Hadaschik  3 , Mulham Al-Nader  3 , Samer Schakaki  4
Affiliations
Review

Factors Contributing to Early Recovery of Urinary Continence Following Radical Prostatectomy: A Narrative Review

Bara Barakat et al. J Clin Med. .

Abstract

Stress urinary incontinence (SUI) is a common condition in patients following radical prostatectomy (RP), which has a significant impact on all aspects of quality of life and is associated with significant social stigma. The factors that improve urinary incontinence in patients following surgery remain controversial. The aim of our narrative review was to identify and synthesise the latest evidence on pre-, intra- and post-operative factors and predictors that contribute to early continence recovery after RP. In this narrative review, primary resources were identified by searching PubMed, EMBASE and Medline, and secondary resources were collected by cross-referencing citations in the relevant articles. We started our review by searching for systematic reviews of factors and predictors that contribute to early recovery of urinary continence after RP. We then reviewed societal guidelines such as the American Urological Association and European Urological Association guidelines on male urinary incontinence. This review focuses on the pre-, intra and postoperative factors that influence postoperative SUI after RP, as well as highlighting modifications in surgical techniques that lead to early continence recovery. Increasing age, higher BMI, shorter membranous urethral length (MUL), and larger PV are independent prognostic factors for SUI within 3 months after RP. Factors such as modified surgical technique preservation of anatomical structure lead to influence postoperative early continence recovery. SUI after RP is influenced by various factors. These factors include not only anatomical landmarks and patient-related factors such as age, BMI, length of MUL and prostate volume, but also prior transurethral resection or laser enucleation of the prostate, the surgeon's expertise, the surgical approach and NS technique.

Keywords: membranous urethral length; nerve-sparing; radical prostatectomy; retzius-sparing radical prostatectomy; stress urinary incontinence.

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Conflict of interest statement

The authors declare they have no relevant conflicts of interest.

Figures

Figure 1
Figure 1
The surgical anatomy of the prostate and axial view of prostatic fascial anatomy. A—intrafascial plane, B—interfascial plane, and C—extrafascial plane with no preservation of neurovascular bundle.
Figure 2
Figure 2
Intraoperative overview, posterior dissection; 1 = intrafascial plane and 2 = extrafascial plane with no preservation of neurovascular bundle.
See this image and copyright information in PMC

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