1872 IMPACT OF PELVIMETRY ON RECOVERY OF POTENCY AND CONTINENCE AND COMPLICATIONS AFTER RADICAL PROSTECTOMY (2010)

You have accessJournal of UrologyProstate Cancer: Localized VIII1 Apr 20101872 IMPACT OF PELVIMETRY ON RECOVERY OF POTENCY AND CONTINENCE AND COMPLICATIONS AFTER RADICAL PROSTECTOMY Christian von Bodman, Mika P. Matikainen, Luis Herran Yunis, James A. Eastham, Jaspreet Sandhu, John P. Mulhall, Peter T. Scardino, Oguz Akin, and Farhang Rabbani Christian von BodmanChristian von Bodman More articles by this author , Mika P. MatikainenMika P. Matikainen More articles by this author , Luis Herran YunisLuis Herran Yunis More articles by this author , James A. EasthamJames A. Eastham More articles by this author , Jaspreet SandhuJaspreet Sandhu More articles by this author , John P. MulhallJohn P. Mulhall More articles by this author , Peter T. ScardinoPeter T. Scardino More articles by this author , Oguz AkinOguz Akin More articles by this author , and Farhang RabbaniFarhang Rabbani More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1812AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The impact of an unfavorable pelvic anatomy on potency, continence and complications after radical prostatectomy (RP) has not been previously evaluated. We sought to determine the influence of pelvimetric measures on the recovery of potency, continence and complications after RP. METHODS Between 11/01 and 06/07, 514 potent men undergoing bilateral nerve-sparing radical retropubic prostatectomy had preoperative MRI where pelvimetry was performed. Outcomes assessed included varying degrees of recovery of erectile function (normal erections, partial erections routinely satisfactory for intercourse and partial erections occasionally satisfactory for intercourse), recovery of continence defined as no pad usage, and medical and surgical complications. Factors assessed as predictors on multivariate Cox proportional hazards analysis included patient age, ethnicity, BMI, co-morbidities, modified Charlson score, preoperative erectile function, prostate weight, surgeon, PSA, stage and Gleason score as well as pelvimetric measures including various bony and soft tissue dimensions to evaluate the pelvic inlet and midplane, prostate size and apical depth. RESULTS None of the pelvimetric measures were significant predictors of any degree of recovery of erectile function. The prostate width (in mm) defined as the width of the prostate at the level of the narrowest distance between the levator muscles was a significant independent predictor of recovery of continence: hazard ratio (HR) 0.97 (95% CI: 0.96-0.99, p=0.003). None of the pelvimetric measures were significant predictors of medical complications after RP. The mid-pelvic area (in cm2) was a significant independent predictor of surgical complications after RP (HR 0.97, 95% CI: 0.95-0.99, p=0.002). CONCLUSIONS Patients with a smaller mid-pelvis have a higher likelihood of surgical complications after RP. Patients with a greater prostate width at the level of the narrowest distance between the levators have a lower likelihood of recovery of continence while pelvimetric measures were not found to be predictive of recovery of erectile function. New York, NY© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e727 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Christian von Bodman More articles by this author Mika P. Matikainen More articles by this author Luis Herran Yunis More articles by this author James A. Eastham More articles by this author Jaspreet Sandhu More articles by this author John P. Mulhall More articles by this author Peter T. Scardino More articles by this author Oguz Akin More articles by this author Farhang Rabbani More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...