Postoperative urinary incontinence after robot-assisted radical prostatectomy (RARP) represents a bothersome side effect which may permanently affect patient quality of life. Several studies have demonstrated that obstructive sleep apnea syndrome (OSAS) is associated with urinary symptoms such as urge incontinence, overactive bladder, and nocturia.
In this study, we sought to further explore the effect of OSAS on urinary continence after RARP.
We queried our prospectively collected institutional RARP database and identified 82 patients with OSAS and 131 controls, which were matched for age and BMI, with available follow-up data for continence. To minimize selection bias, we conducted a propensity score-matched analysis. Patient's characteristics and urinary continence outcomes were compared between the two groups before and after propensity-score matching. Kaplan-Meier curves were constructed to assess the difference in continence between the two groups.
A total of 213 patients were included in the analysis, of whom 82 with OSAS and 131 with non-OSAS (control group). The mean age of the total cohort was 61.7 6.96 years, the mean BMI was 30.4 5.36, and 52% of the cohort were classified as obese (BMI ≥ 30). In post-propensity score-matched analyses, there was no significant difference in baseline demographics and tumor characteristics between the two groups (included 82 cases in each group). The median time to continence was 6.6 months for the control group as compared to 13.0 months for the OSAS group (p<0.001). At 12 months the continence rate for the OSAS group was 41.2% as compared to 61.7% for the control group. At 24 months the continence rate for the OSAS group was 68.7% as compared to 90.8% for the control group.
On matched analysis, we found that patients with OSAS tended to demonstrate worse urinary continence recovery as compared to patients without OSAS.
Journal of endourology. 2023 Jun 02 [Epub ahead of print]
Mohammed Shahait, Tuan Thanh Nguyen, Jose M El-Asmar, Ryan W Dobbs, Jeffrey Walker, Jessica L Kim, Ayah El-Fahmawi, David I Lee
University of Pittsburgh Medical Center, 6595, Urology , Kauffman Medical Building , 3471 fifth ave, Suite 700, Pennsylvania, Pittsburgh, Pennsylvania, United States, 15213-2582; ., University of Medicine and Pharmacy Ho Chi Minh City Faculty of Medicine, 305940, 217 Hong Bang Street, Ward 11, District 5 Ho Chi Minh City, Ho Chi Minh City, Viet Nam, 70000., American University of Beirut, 11238, American University of Beirut Medical CenterRiad El- Solh 1107 2020, Beirut, Lebanon, Beirut, Lebanon, 1107 2020; ., University of Pennsylvania Perelman School of Medicine, 14640, Surgery, 3400 Spruce Street, 4 Maloney, Philadelphia, Philadelphia, Pennsylvania, United States, 19104; ., University of Pennsylvania, 6572, Department of Surgery, Division of Urology, Philadelphia, Pennsylvania, United States; ., University of Pennsylvania, 6572, Department of Surgery, Division of Urology, Philadelphia, Pennsylvania, United States; ., University of Pennsylvania, 6572, Department of Surgery, Division of Urology, Philadelphia, Pennsylvania, United States; ., University of California Irvine, 8788, Urology, Irvine, California, United States; .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/37265125