Patient- and Tumour-Related Prognostic Factors for Urinary Incontinence After Radical Prostatectomy for Nonmetastatic Prostate Cancer: A Systematic Review and Meta-Analysis - Beyond the Abstract

In our systematic review titled "Patient- and Tumour-related Prognostic Factors for Urinary Incontinence After Radical Prostatectomy for Nonmetastatic Prostate Cancer: A Systematic Review and Meta-analysis," undertaken by the European Association of Urology (EAU) Prostate Cancer Guidelines, we analyzed patient- and tumour-related prognostic factors for post-radical prostatectomy (RP) urinary incontinence (UI). 119 studies with 131.379 patients were included.



Significant prognostic factors for postoperative UI within 3 months after RP were age (OR: 1.04, 95% CI: 1.03–1.05), membranous urethral length (OR: 0.81, 95% CI: 0.74–0.88), prostate volume (OR: 1.005, 95% CI: 1.000–1.011) and Charlson comorbidity index (OR: 1.28, 95% CI: 1.09–1.50). Body mass index (BMI) and preoperative PSA were not associated with postoperative UI, while there was a lack of data for the role of IPSS. Moreover, there were insufficient data to draw any conclusions for the role of biopsy Gleason score and clinical stage. Surgical and technical parameters were not included in our SR, since the analysis of these factors was beyond the scope of our review.

The Risk of Bias (RoB) was moderate to high and there was substantial heterogeneity in design and analysis choices. Variation in surgical or technical factors may have contributed to the high degree of statistical heterogeneity encountered and our findings may have been confounded by these factors. In conclusion, age, membranous urethral length, prostate volume and Charlson comorbidity index can be used to guide risk stratification and patient counseling in clinical practice.

Written by: Michael Lardas, Nikos Grivas, Thomas P A Debray, Fabio Zattoni, Christopher Berridge, Marcus Cumberbatch, Thomas Van den Broeck, Erik Briers, Maria De Santis, Andrea Farolfi, Nicola Fossati, Giorgio Gandaglia, Silke Gillessen, Shane O'Hanlon, Ann Henry, Matthew Liew, Malcolm Mason, Lisa Moris, Daniela Oprea-Lager, Guillaume Ploussard, Olivier Rouviere, Ivo G Schoots, Theodorus van der Kwast, Henk van der Poel, Thomas Wiegel, Peter-Paul Willemse, Cathy Y Yuan, Jeremy P Grummet, Derya Tilki, Roderick C N van den Bergh, Thomas B Lam, Philip Cornford, Nicolas Mottet

Department of Urology, Metropolitan General Hospital, Athens, Greece. Electronic address: ., Department of Urology, University General Hospital of Heraklion, University of Crete Medical School, Heraklion, Greece., Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands., Urology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy., Worcestershire Acute Hospitals NHS Trust, Redditch, UK., Academic Urology Unit, University of Sheffield, Sheffield, UK., Department of Urology, University Hospitals Leuven, Leuven, Belgium., Patient Advocate, Hasselt, Belgium., Department of Urology, Charité Universitätsmedizin Berlin, Germany; Department of Urology, Medical University of Vienna, Vienna, Austria., Nuclear Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, Bologna, Italy., Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy., Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Università della Svizzera Italiana, Lugano, Switzerland., Medicine for Older People, Saint Vincent's University Hospital, Dublin, Ireland., Leeds Cancer Centre, St. James's University Hospital and University of Leeds, Leeds, UK., Department of Urology, Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust, Wigan, UK., Division of Cancer & Genetics, Cardiff University School of Medicine, Velindre Cancer Centre, Cardiff, UK., Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands., La Croix du Sud Hospital, Quint Fonsegrives, France., Department of Urinary and Vascular Imaging, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France., Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands., Department of Pathology, Erasmus MC University Medical Center, Rotterdam, The Netherlands., Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands., Department of Radiation Oncology, University Hospital Ulm, Ulm, Germany., Department of Oncological Urology, University Medical Center, Utrecht Cancer Center, Utrecht, The Netherlands., Department of Medicine, Health Science Centre, McMaster University, Hamilton, ON, Canada., Department of Surgery, Central Clinical School, Monash University, Melbourne, Australia., Martini-Klinik Prostate Cancer Center, and Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany., Department of Urology, Antonius Hospital, Utrecht, The Netherlands., Department of Urology, Aberdeen Royal Infirmary, Aberdeen, UK., Royal Liverpool and Broadgreen Hospitals NHS Trust, Liverpool, UK., Department of Urology, University Hospital, St. Etienne, France.

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