Urethral mobility at catheter removal predicts early recovery of urinary continence after radical prostatectomy.

OBJECTIVES

To analyze the clinical parameters correlated with early recovery of urinary continence after radical prostatectomy, focusing especially on urethral mobility during voiding at catheter removal.

METHODS

At the time of catheter removal, a voiding cystourethrography was performed in 58 men (median age 69 years, range 55-76) who had undergone radical prostatectomy. The vertical length of urethral movement between voiding and standstill was measured.The correlation between continence status and various clinical parameters, including age, prostate volume, International Prostate Symptom Score, quality of life score and the length of urethral movement was analyzed.

RESULTS

An inverse correlation was observed between length of urethral movement and urinary incontinence volume rate (defined as [leakage volume/daily total urine volume] x 100%) on day 7 after catheter removal (r = -0.388, P < 0.05). Classifying patients into two groups according to the length of urethral movement of 2 mm gave the best accuracy for the prediction of postoperative recovery of urinary incontinence with receiver operating characteristic analysis. A statistically significant difference was observed between group 1 (length >or=2 mm) and group 2(<2 mm) for the leakage rate until day 7 after the catheter was removed (P < 0.01). Urethral movement at the time of catheter removal was significantly correlated with early recovery of continence in the two groups (P < 0.05).

CONCLUSIONS

Urethral mobility after radical prostatectomy, which can be easily evaluated using voiding cystourethrography, may be a good predictor of early recovery of urinary continence.