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Pre‐prostatectomy membranous urethral length as a predictive factor of post prostatectomy incontinence requiring surgical intervention with an artificial urinary sphincter or a male sling

AIMS: To ascertain whether the membranous urethral length (MUL) is predictive of postprostatectomy incontinence (PPI) that requires surgery such as artificial urinary sphincter (AUS) or male sling (MS). METHODS: Men who had undergone AUS or MS for PPI were identified from a prospectively maintained...

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Autores principales: Oza, Priyanka, Walker, Nicholas Faure, Rottenberg, Giles, MacAskill, Findlay, Malde, Sachin, Taylor, Claire, Sahai, Arun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9313820/
https://www.ncbi.nlm.nih.gov/pubmed/35266177
http://dx.doi.org/10.1002/nau.24904
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author Oza, Priyanka
Walker, Nicholas Faure
Rottenberg, Giles
MacAskill, Findlay
Malde, Sachin
Taylor, Claire
Sahai, Arun
author_facet Oza, Priyanka
Walker, Nicholas Faure
Rottenberg, Giles
MacAskill, Findlay
Malde, Sachin
Taylor, Claire
Sahai, Arun
author_sort Oza, Priyanka
collection PubMed
description AIMS: To ascertain whether the membranous urethral length (MUL) is predictive of postprostatectomy incontinence (PPI) that requires surgery such as artificial urinary sphincter (AUS) or male sling (MS). METHODS: Men who had undergone AUS or MS for PPI were identified from a prospectively maintained database and compared to a control group of men who were continent at 12 months after radical prostatectomy. MUL in sagittal and coronal planes, sphincter height and width were measured on prebiopsy T2‐weighted MRI scans. Sphincter volume was estimated as an ellipsoid cylinder. RESULTS: A total of 95 patients (64 AUS and 31 MS) were compared to 60 continent controls. There was no statistical difference in presenting PSA, prostate volume, and T‐stage. The mean MUL in sagittal and coronal planes was 11.31 mm (SD: 2.6, range: 6–17 mm) and 11.43 mm (SD: 2.94, range: 5–17 mm) in patients who had AUS and MS, respectively; 15.23 mm (SD: 4.2, range: 8.25–25 mm) and 15.75 mm (SD: 4.1, range: 8–24 mm) in controls (p < 0.01). No men in the PPI surgery group had an MUL >17 mm compared to 35% (20/57 sagittal, 20/58 coronal) of controls. The odds ratio for requiring surgery for PPI was 13.4 for sagittal MUL <9 mm and 3.2 if the MUL <12 mm. CONCLUSIONS: Patients who had surgery for PPI had a significantly shorter MUL and sphincter volume than continent controls. Men with an MUL >17 mm are unlikely to require surgery for PPI whereas an MUL <12 mm significantly increases the risk of requiring surgery for PPI. MUL should be considered when discussing treatment options for prostate cancer.
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spelling pubmed-93138202022-07-30 Pre‐prostatectomy membranous urethral length as a predictive factor of post prostatectomy incontinence requiring surgical intervention with an artificial urinary sphincter or a male sling Oza, Priyanka Walker, Nicholas Faure Rottenberg, Giles MacAskill, Findlay Malde, Sachin Taylor, Claire Sahai, Arun Neurourol Urodyn Clinical Articles AIMS: To ascertain whether the membranous urethral length (MUL) is predictive of postprostatectomy incontinence (PPI) that requires surgery such as artificial urinary sphincter (AUS) or male sling (MS). METHODS: Men who had undergone AUS or MS for PPI were identified from a prospectively maintained database and compared to a control group of men who were continent at 12 months after radical prostatectomy. MUL in sagittal and coronal planes, sphincter height and width were measured on prebiopsy T2‐weighted MRI scans. Sphincter volume was estimated as an ellipsoid cylinder. RESULTS: A total of 95 patients (64 AUS and 31 MS) were compared to 60 continent controls. There was no statistical difference in presenting PSA, prostate volume, and T‐stage. The mean MUL in sagittal and coronal planes was 11.31 mm (SD: 2.6, range: 6–17 mm) and 11.43 mm (SD: 2.94, range: 5–17 mm) in patients who had AUS and MS, respectively; 15.23 mm (SD: 4.2, range: 8.25–25 mm) and 15.75 mm (SD: 4.1, range: 8–24 mm) in controls (p < 0.01). No men in the PPI surgery group had an MUL >17 mm compared to 35% (20/57 sagittal, 20/58 coronal) of controls. The odds ratio for requiring surgery for PPI was 13.4 for sagittal MUL <9 mm and 3.2 if the MUL <12 mm. CONCLUSIONS: Patients who had surgery for PPI had a significantly shorter MUL and sphincter volume than continent controls. Men with an MUL >17 mm are unlikely to require surgery for PPI whereas an MUL <12 mm significantly increases the risk of requiring surgery for PPI. MUL should be considered when discussing treatment options for prostate cancer. John Wiley and Sons Inc. 2022-03-09 2022-04 /pmc/articles/PMC9313820/ /pubmed/35266177 http://dx.doi.org/10.1002/nau.24904 Text en © 2022 The Authors. Neurourology and Urodynamics published by Wiley Periodicals LLC https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Clinical Articles
Oza, Priyanka
Walker, Nicholas Faure
Rottenberg, Giles
MacAskill, Findlay
Malde, Sachin
Taylor, Claire
Sahai, Arun
Pre‐prostatectomy membranous urethral length as a predictive factor of post prostatectomy incontinence requiring surgical intervention with an artificial urinary sphincter or a male sling
title Pre‐prostatectomy membranous urethral length as a predictive factor of post prostatectomy incontinence requiring surgical intervention with an artificial urinary sphincter or a male sling
title_full Pre‐prostatectomy membranous urethral length as a predictive factor of post prostatectomy incontinence requiring surgical intervention with an artificial urinary sphincter or a male sling
title_fullStr Pre‐prostatectomy membranous urethral length as a predictive factor of post prostatectomy incontinence requiring surgical intervention with an artificial urinary sphincter or a male sling
title_full_unstemmed Pre‐prostatectomy membranous urethral length as a predictive factor of post prostatectomy incontinence requiring surgical intervention with an artificial urinary sphincter or a male sling
title_short Pre‐prostatectomy membranous urethral length as a predictive factor of post prostatectomy incontinence requiring surgical intervention with an artificial urinary sphincter or a male sling
title_sort pre‐prostatectomy membranous urethral length as a predictive factor of post prostatectomy incontinence requiring surgical intervention with an artificial urinary sphincter or a male sling
topic Clinical Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9313820/
https://www.ncbi.nlm.nih.gov/pubmed/35266177
http://dx.doi.org/10.1002/nau.24904
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