Session: MP80: Prostate Cancer: Localized: Surgical Therapy IV
MP80-11: Impact of obstructive sleep apnea syndrome on time to complete recovery of continence after robot‐assisted radical prostatectomy: An Analysis Using Propensity Score Matching
Introduction: Postoperative urinary incontinence after robot-assisted radical prostatectomy (RARP) represents a bothersome side effect which may permanently affect patient quality of life. The urinary continence rate after RARP depends on several factors, including baseline continence, age, body mass index (BMI), prostate volume, surgeon experience, pre-existing lower urinary tract symptoms, & surgical technique. Several studies have demonstrated that obstructive sleep apnea syndrome (OSAS) is associated with urge incontinence, overactive bladder, & nocturia. In this study, we sought to further explore the effect of OSAS on urinary continence (UC) after RARP. Methods: We queried our prospectively collected institutional RARP database & identified 84 patients with OSAS & 131 controls, which were matched for age & BMI, with available follow-up data for UC. To minimize selection bias, we conducted a propensity score-matched analysis. Patient characteristics & UC outcomes were compared between the two groups before & after propensity-score matching. Continence was defined as using zero pads. Kaplan-Meier curves were constructed to assess the difference in UC between the two groups. Results are presented as means with standard deviations & percentages with 95% confidence intervals. Results: A total of 213 patients were included in the analysis, of whom 82 with OSAS & 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, & 52% of the cohort was classified as obese (BMI = 30). In post-propensity score-matched analyses, there was no significant difference in baseline demographics & laboratory tests between the two groups (included 82 cases in each group). The median time to UC 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 UC rate for the OSAS group was 41.2% (95% CI: 28.9%-51.4%) as compared to 61.7% (95% CI: 28.5%-71.5%) for the control group. At 24 months the UC rate for the OSAS group was 68.7% (95% CI: 56%-77.7%) as compared to 90.8% (95% CI: 79%-96%) for the control group. Conclusions: On matched analysis, we found that patients with OSAS tended to demonstrate worse UC recovery than patients without OSAS. If these findings were confirmed in other cohorts, it might help urologist to counsel these patients pre-operatively. SOURCE OF Funding: None
