The Association between Specimen Neuromuscular Characteristics and Urinary Incontinence after Robotic-Assisted Radical Prostatectomy

Urinary incontinence after robotic-assisted radical prostatectomy (RARP) has been associated with older age, a longer operative time, a higher BMI, a short membranous urethral length and preoperative erectile function. The authors sought to assess the association between the neuromuscular characteri...

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Main Authors: Tomer Bashi, Jonathan Margalioth, Ziv Savin, Ron Marom, Snir Dekalo, Ibrahim Fahoum, Rabab Naamneh, Roy Mano, Ofer Yossepowitch
Format: Article
Language:English
Published: MDPI AG 2024-09-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/14/18/2001
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author Tomer Bashi
Jonathan Margalioth
Ziv Savin
Ron Marom
Snir Dekalo
Ibrahim Fahoum
Rabab Naamneh
Roy Mano
Ofer Yossepowitch
author_facet Tomer Bashi
Jonathan Margalioth
Ziv Savin
Ron Marom
Snir Dekalo
Ibrahim Fahoum
Rabab Naamneh
Roy Mano
Ofer Yossepowitch
author_sort Tomer Bashi
collection DOAJ
description Urinary incontinence after robotic-assisted radical prostatectomy (RARP) has been associated with older age, a longer operative time, a higher BMI, a short membranous urethral length and preoperative erectile function. The authors sought to assess the association between the neuromuscular characteristics and postoperative urinary incontinence. Methods: RARP specimens from 29 men who underwent bilateral nerve sparing were reanalyzed. Urinary incontinence was evaluated using the International Consultation on Incontinence Questionnaire—Short Form (ICIQ-SF) at 6 weeks post surgery and last follow-up. Linear and logistic regression analyses were performed to assess neuromuscular characteristics and incontinence. Results: At the 1-year follow-up, 11 patients (38%) reported severe incontinence (>12 ICIQ-SF score). The median number of peripheral nerves observed at the base and apex in the specimens was 52 (IQR 13–139) and 59 (IQR: 28–129), respectively. Ganglia were present in 19 patients (65%) at the base and 12 patients (41%) at the apex. Additionally, the median proportional area of detrusor smooth muscle fibers at the base was 0.54 (IQR 0.31–1), while the median proportional area of striated muscle fibers at the apex was 0.13 (IQR 0.08–0.24). No statistically significant associations were found. Conclusions: Histologic neuromuscular characteristics were not associated with postoperative urinary incontinence. Enhanced intraoperative evaluation and larger-scale studies may prove useful for the prediction of postprostatectomy incontinence.
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spelling doaj-art-c6fade61651c4c828307c8ed0714da4c2025-08-20T01:55:30ZengMDPI AGDiagnostics2075-44182024-09-011418200110.3390/diagnostics14182001The Association between Specimen Neuromuscular Characteristics and Urinary Incontinence after Robotic-Assisted Radical ProstatectomyTomer Bashi0Jonathan Margalioth1Ziv Savin2Ron Marom3Snir Dekalo4Ibrahim Fahoum5Rabab Naamneh6Roy Mano7Ofer Yossepowitch8Department of Urology, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, IsraelDepartment of Urology, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, IsraelDepartment of Urology, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, IsraelDepartment of Urology, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, IsraelDepartment of Urology, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, IsraelPathology Department, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, IsraelPathology Department, Rabin Medical Center, Petah Tikva 4941492, IsraelDepartment of Urology, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, IsraelDepartment of Urology, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, IsraelUrinary incontinence after robotic-assisted radical prostatectomy (RARP) has been associated with older age, a longer operative time, a higher BMI, a short membranous urethral length and preoperative erectile function. The authors sought to assess the association between the neuromuscular characteristics and postoperative urinary incontinence. Methods: RARP specimens from 29 men who underwent bilateral nerve sparing were reanalyzed. Urinary incontinence was evaluated using the International Consultation on Incontinence Questionnaire—Short Form (ICIQ-SF) at 6 weeks post surgery and last follow-up. Linear and logistic regression analyses were performed to assess neuromuscular characteristics and incontinence. Results: At the 1-year follow-up, 11 patients (38%) reported severe incontinence (>12 ICIQ-SF score). The median number of peripheral nerves observed at the base and apex in the specimens was 52 (IQR 13–139) and 59 (IQR: 28–129), respectively. Ganglia were present in 19 patients (65%) at the base and 12 patients (41%) at the apex. Additionally, the median proportional area of detrusor smooth muscle fibers at the base was 0.54 (IQR 0.31–1), while the median proportional area of striated muscle fibers at the apex was 0.13 (IQR 0.08–0.24). No statistically significant associations were found. Conclusions: Histologic neuromuscular characteristics were not associated with postoperative urinary incontinence. Enhanced intraoperative evaluation and larger-scale studies may prove useful for the prediction of postprostatectomy incontinence.https://www.mdpi.com/2075-4418/14/18/2001incontinenceradical prostatectomyneuromuscular features
spellingShingle Tomer Bashi
Jonathan Margalioth
Ziv Savin
Ron Marom
Snir Dekalo
Ibrahim Fahoum
Rabab Naamneh
Roy Mano
Ofer Yossepowitch
The Association between Specimen Neuromuscular Characteristics and Urinary Incontinence after Robotic-Assisted Radical Prostatectomy
Diagnostics
incontinence
radical prostatectomy
neuromuscular features
title The Association between Specimen Neuromuscular Characteristics and Urinary Incontinence after Robotic-Assisted Radical Prostatectomy
title_full The Association between Specimen Neuromuscular Characteristics and Urinary Incontinence after Robotic-Assisted Radical Prostatectomy
title_fullStr The Association between Specimen Neuromuscular Characteristics and Urinary Incontinence after Robotic-Assisted Radical Prostatectomy
title_full_unstemmed The Association between Specimen Neuromuscular Characteristics and Urinary Incontinence after Robotic-Assisted Radical Prostatectomy
title_short The Association between Specimen Neuromuscular Characteristics and Urinary Incontinence after Robotic-Assisted Radical Prostatectomy
title_sort association between specimen neuromuscular characteristics and urinary incontinence after robotic assisted radical prostatectomy
topic incontinence
radical prostatectomy
neuromuscular features
url https://www.mdpi.com/2075-4418/14/18/2001
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