To evaluate whether an age < 55 years is independently associated with early urinary continence recovery after robot-assisted radical prostatectomy (RARP) in a large multi-institutional Japanese cohort.
The cohort comprised 5349 patients aged < 75 years with clinically localized prostate cancer (cT1-2N0M0) who underwent RARP at Japanese tertiary care centers from August 2011 to April 2023. The primary analysis consisted of a 1:1 propensity score-matched comparison between men aged < 55 and 55-74 years. Covariates used for matching included American Society of Anesthesiologists physical status, clinical T stage, biopsy International Society of Urological Pathology grade group, prostate-specific antigen, prostate volume, nerve-sparing status, pelvic lymph node dissection, and surgical approach. Early urinary continence, biochemical recurrence-free survival, and surgical outcomes were evaluated using logistic regression and Cox proportional hazards models in the matched cohort.
After propensity score matching, 158 well-balanced matched pairs were generated. A younger age (< 55 years) was significantly associated with higher odds of early continence at 1 month (odds ratio: 1.66, 95% confidence interval [CI]: 1.04-2.65) and 3 months (odds ratio: 2.22, 95% CI: 1.32-3.73). Five-year biochemical recurrence-free survival was similar between men aged < 55 and 55-74 years (86.2% vs. 84.8%). In an exploratory three-group analysis, continence recovery showed a graded age-related pattern.
In this large Japanese cohort, an age < 55 years was independently associated with early urinary continence recovery after RARP without compromising oncological outcomes. These findings provide age-specific evidence to support preoperative counseling and surgical decision-making in younger patients.
International journal of urology : official journal of the Japanese Urological Association. 2026 Jun [Epub]
Hiroki Hagimoto, Masashi Kubota, Kei Mizuno, Takayuki Sumiyoshi, Kimihiko Masui, Yoshiyuki Matsui, Ryoichi Saito, Shigeki Fukuzawa, Yosuke Shimizu, Toru Yoshida, Toshiya Akao, Takehiko Segawa, Kimihiro Shimatani, Yuya Sekine, Ryoma Kurahashi, Atsuro Sawada, Hiromitsu Negoro, Shusuke Akamatsu, Takashi Kobayashi, Takayuki Goto, Daimonji Clinical Application Database (Dai‐CAD)
Department of Urology, National Cancer Center Hospital, Tokyo, Japan., Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan., Department of Urology, Hyogo Medical University, Hyogo, Japan., Department of Urology, Shimada General Medical Center, Shizuoka, Japan., Department of Urology, Osaka Red Cross Hospital, Osaka, Japan., Department of Urology, Shiga General Hospital, Moriyama, Shiga, Japan., Department of Urology, Rakuwakai Otowa Hospital, Kyoto, Japan., Department of Urology, Kyoto City Hospital, Kyoto, Japan., Department of Urology, Akita University Graduate School of Medicine, Akita, Japan., Department of Urology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan., Department of Urology, Miyazaki University, Miyazaki, Japan., Department of Urology, University of Tsukuba, Tsukuba, Japan., Department of Urology, Nagoya University, Nagoya, Japan.