*[1000] ANALYSIS OF CONTINENCE RATES FOLLOWING ROBOTIC RADICAL PROSTATECTOMY: STRICT LEAK- AND PAD-FREE CONTINENCE RATES OUTCOMES* *//W Stuart Reynolds*,/ /Sergey A Shikanov,/ /Ofer N Gofrit,/ /Mark H Katz,/ /Michael K Eng,/ /Andrew J Bernstein,/ /Gregory P Zagaja,/ /Arieh L Shalhav,/ /Kevin C Zorn,/ Chicago, IL /* INTRODUCTION AND OBJECTIVE: Post-prostatectomy incontinence (PPI) has been ill-defined in the literature and a wide range of outcomes have been reported depending on the definition of continence employed. Based on the UCLA-Prostate Cancer Index (UCLA-PCI) questionnaire, a patient self-reported, validated instrument, we evaluated our robot-assisted laparoscopic prostatectomy (RALP) outcomes using the strictest definition available, that of leak- and pad-free (L/PF) continence. METHODS: A review of a single institutions RALP database was performed concerning patient-reported continence variables as prospectively recorded by the UCLA-PCI administered to all patients undergoing RALP. Specific responses to items concerning urinary function and continence (Items #12-16) were reviewed at baseline and 1, 3, 6, 12, and 24 months post-operatively. RESULTS: Of over 1200 RALP performed since February 2003, 885 patients were available for review. Patient demographics for this cohort have previously been reported and are similar to other institutions. At baseline, only 642/885 (73%) of men were L/PF before surgery. This decreased to 19/504 (4%), 56/656 (9%), 92/585 (16%), 97/408 (24%), and 37/128 (27%) at 1, 3, 6, 12, and 24 months postoperatively, respectively. Of those that were not L/PF at baseline, 237/882 (27%) reported leakage and 28/882 (3%) wore pads. Patients who reported L/PF at baseline disproportionately regained L/PF continence post-operatively vs. those who were not L/PF at baseline: 4 vs. 3% (NS), 10 vs. 6% (NS), 19 vs. 9% (p=0.005), 29 vs. 13% (p=0.0009), and 33 vs. 13% (p=0.0146), at 1, 3, 6, 12 and 24 months, respectively. Overall, when continence is defined more liberally as leak-free security pad, 19%, 50%, 73%, 86% and 85% of patients were continent at 1, 3, 6, 12, and 24 months, respectively. CONCLUSIONS: As expected, a stricter definition of urinary continence results in more conservative post-operative outcomes reporting. Our data suggest that baseline urinary incontinence can be predictive of a failure to regain L/PF continence starting at 6 months postoperatively. However, only one third of patients who were L/PF at baseline achieved this state at 24 months. Continued evaluation and standardization of the definition of PPI is warranted and should be applied to outcomes after RALP. Monday, May 19, 2008 1:00 PM *Moderated Poster Session 35: Technology Instruments: Laparoscopy, Ureteroscopy (III) (1:00 PM-3:00 PM)* Close Window