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<p>To develop a risk stratification model for predicting urinary incontinence at 3 months after robot-assisted laparoscopic radical prostatectomy (RARP) in prostate cancer (PCa) patients based on their perioperative clinicopathological data. A retrospective analysis was conducted on 412 PCa patients who underwent RARP between August 2020 and January 2022 (training set, n = 288; test set, n = 124). Clinical characteristics were reviewed by univariable and multivariate logistic regression analyses to identify significant predictors for constructing a nomogram. Urinary incontinence status at 3 months postoperatively was assessed based on postoperative pad usage. Urinary incontinence rates at 3 months postoperatively were 18.45%. The independent predictive factors for early urinary incontinence were higher preoperative PSA level (PSA ≥ 20 ng/mL vs. &lt;4 ng/mL; OR = 22.80, P = 0.025), preoperative urinary tract infection (OR = 7.62, P = 0.003), membranous urethral length (OR = 0.63, P = 0.017), history of mid-upper abdominal surgery (OR = 4.13, P = 0.027), history of lower abdominal surgery (OR = 59.61, P &lt; 0.001), underlying diseases (OR = 3.37, P = 0.018), prostate volume (60–89.9 mL vs. &lt;30 mL: OR = 29.72, P = 0.042; ≥90 mL vs. &lt;30 mL: OR = 39.81, P = 0.046), bladder neck preservation (OR = 0.16, P = 0.021), and urinary fistula (OR = 12.08, P = 0.004). The nomogram based on these factors showed good predictive performance, with AUC of 0.937 in the test set. The developed nomogram enables effective risk stratification for post-RARP urinary incontinence in PCa patients, thereby facilitating personalized management and rehabilitation strategies.</p>

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Development and Validation of a Nomogram for the Preoperative Prediction of Early Urinary Incontinence Following Robot-Assisted Laparoscopic Radical Prostatectomy

  • 期刊论文

  • 发表日期：

    2026年3月26日

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  • Jing Tang,
  • Xiaomin Yi,
  • Jingru Chen,
  • Murong Zhu,
  • Qingli Chen

摘要

To develop a risk stratification model for predicting urinary incontinence at 3 months after robot-assisted laparoscopic radical prostatectomy (RARP) in prostate cancer (PCa) patients based on their perioperative clinicopathological data. A retrospective analysis was conducted on 412 PCa patients who underwent RARP between August 2020 and January 2022 (training set, n = 288; test set, n = 124). Clinical characteristics were reviewed by univariable and multivariate logistic regression analyses to identify significant predictors for constructing a nomogram. Urinary incontinence status at 3 months postoperatively was assessed based on postoperative pad usage. Urinary incontinence rates at 3 months postoperatively were 18.45%. The independent predictive factors for early urinary incontinence were higher preoperative PSA level (PSA ≥ 20 ng/mL vs. <4 ng/mL; OR = 22.80, P = 0.025), preoperative urinary tract infection (OR = 7.62, P = 0.003), membranous urethral length (OR = 0.63, P = 0.017), history of mid-upper abdominal surgery (OR = 4.13, P = 0.027), history of lower abdominal surgery (OR = 59.61, P < 0.001), underlying diseases (OR = 3.37, P = 0.018), prostate volume (60–89.9 mL vs. <30 mL: OR = 29.72, P = 0.042; ≥90 mL vs. <30 mL: OR = 39.81, P = 0.046), bladder neck preservation (OR = 0.16, P = 0.021), and urinary fistula (OR = 12.08, P = 0.004). The nomogram based on these factors showed good predictive performance, with AUC of 0.937 in the test set. The developed nomogram enables effective risk stratification for post-RARP urinary incontinence in PCa patients, thereby facilitating personalized management and rehabilitation strategies.