Intermediate-term follow-up and analysis of related factors associated with urinary incontinence and overactive bladder after laparoscopic radical prostatectomy—A multicenter cross-sectional study in China

Purpose: The aim of this study was to evaluate the incidence of urinary incontinence (UI) and overactive bladder (OAB) in prostate cancer patients 12 months after laparoscopic radical prostatectomy (LRP), through a multicenter follow-up. Additionally, the study sought to analyze the association between potential risk factors and the occurrence of these complications. Methods: This retrospective study included 382 patients who underwent LRP across 9 institutions in Jiangsu Province, China, between January 2019 and March 2020. Clinical data, including the Overactive Bladder Symptom Score, the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form, magnetic resonance imaging findings, and the number of pads used, were collected 12 months postoperatively to assess the incidence of UI and OAB. Univariate and multivariate analyses were conducted to identify factors associated with UI and bladder overactivity at the 12-month follow-up. Results: Among the 382 patients included in the analysis, 135 (35.34%) patients remained affected by UI 12 months after LRP. Multivariate statistical analysis identified membranous urethral length (MUL), body mass index (BMI), and age as significant predictors of UI at the 12 - month postoperative mark. Additionally, 139 (36.39%) patients reported the presence of overactive bladder (OAB) 12 months post - operation. UI and OAB were found to be risk factors for each other. Conclusions: In our multicenter retrospective study, the prevalence of UI and OAB 12 months after LRP was significantly higher than previously reported in the literature. Age, BMI, and MUL were found to be associated with postoperative UI. Notably, preoperative MUL served as a protective factor against UI at 12 months post-surgery, while UI and OAB were identified as mutual risk factors. These findings underscore the importance of preventing post-prostatectomy UI to mitigate or avoid the occurrence of postoperative OAB. It should be noted that the loss-to-follow-up rate in this study was 39.7%, which may limit the interpretation and generalizability of the results.