Impact of Diabetes Mellitus on Urinary Continence Recovery after Radical Prostatectomy: a Systematic Review and Meta-Analysis
5 January 2019
To evaluate the impact of diabetes mellitus (DM) on the recovery of urinary continence (UC) after radical prostatectomy (RP).
Trials were identified in a literature search of PubMed, Embase, Cochrane Library and Web of Science using appropriate search terms. All comparative studies reporting diabetes mellitus, study characteristics, and outcome data including the relationship between diabetes mellitus and urinary continence data were included. Continence rates at different time after RP were compared. Odds ratio (OR) was used for the comparison and all the results were presented with 95% confidence intervals (CIs).
7 cohort studies comprising with 5944 participants were included, the percentage of DM patients was 8.7%. The results showed that DM increased urinary incontinence risk at 12 months after RP (OR 0.54, 95%CI 0.36 to 0.81, ????=0.003). The continence rates were not significantly different between DM and Non-DM groups at short-term (catheter removal, 3 months, 6 months) and long-term (>12 months). When stratified by the surgical methods, the pooled results showed similar results in patients who underwent robot -assisted radical prostatectomy (RARP).
DM has an adverse impact on the recovery of UC during the intermediate-term after RP. Well-designed trials with strict control of confounders are needed to make results more comparable.
- urinary continence?diabetes mellitus
- radical prostatectomy
- prostate cancer
How to Cite
Punnen S, Cowan JE, Chan JM, Carroll PR, Cooperberg MR. Long-term health-related quality of life after primary treatment for localized prostate cancer: results from the CaPSURE registry. Eur Urol. 2015;68(4):600-608.
Holm HV, Fossa SD, Hedlund H, Schultz A, Dahl AA. How should continence and incontinence after radical prostatectomy be evaluated? A prospective study of patient ratings and changes with time. The Journal of urology. 2014;192(4):1155-1161.
Matsushita K, Kent MT, Vickers AJ, et al. Preoperative predictive model of recovery of urinary continence after radical prostatectomy. BJU Int. 2015;116(4):577-583.
Lee S, Yoon CJ, Park HJ, Lee JZ, Ha HK. The surgical procedure is the most important factor affecting continence recovery after laparoscopic radical prostatectomy. World J Mens Health. 2013;31(2):163-169.
Gandhi J, Dagur G, Warren K, Smith NL, Khan SA. Genitourinary Complications of Diabetes Mellitus: An Overview of Pathogenesis, Evaluation, and Management. Curr Diabetes Rev. 2017;13(5):498-518.
Esteghamati A, Rashidi A, Nikfallah A, Yousefizadeh A. The association between urodynamic findings and microvascular complications in patients with long-term type 2 diabetes but without voiding symptoms. Diabetes Res Clin Pract. 2007;78(1):42-50.
Lo CK, Mertz D, Loeb M. Newcastle-Ottawa Scale: comparing reviewers' to authors' assessments. BMC Med Res Methodol. 2014;14:45.
Wille S, Heidenreich A, von Knobloch R, Hofmann R, Engelmann U. Impact of comorbidities on post-prostatectomy incontinence. Urologia Internationalis. 2006;76(3):223-226.
Teber D, Sofikerim M, Ates M, et al. Is Type 2 Diabetes Mellitus a Predictive Factor for Incontinence After Laparoscopic Radical Prostatectomy? A Matched Pair and Multivariate Analysis. Journal of Urology. 2010;183(3):1087-1091.
Nilsson AE, Schumacher MC, Johansson E, et al. Age at surgery, educational level and long-term urinary incontinence after radical prostatectomy. Bju International. 2011;108(10):1572-1577.
Mao Q, Lin Y, Chen H, et al. Preoperative risk factors for early postoperative urinary continence recovery after non-nerve-sparing radical prostatectomy in Chinese patients: a single institute retrospective analysis. Int J Clin Exp Med. 2015;8(8):14105-14109.
Song W, Kim CK, Park BK, et al. Impact of preoperative and postoperative membranous urethral length measured by 3 Tesla magnetic resonance imaging on urinary continence recovery after robotic-assisted radical prostatectomy. Cuaj-Canadian Urological Association Journal. 2017;11(3-4):E93-E99.
Cakmak S, Canda AE, Ener K, Atmaca AF, Altinova S, Balbay MD. Does Type 2 Diabetes Mellitus Have an Impact on Postoperative Early, Mid-Term and Late-Term Urinary Continence After Robot-Assisted Radical Prostatectomy? Journal of Endourology. 2019;33(3):201-206.
Manfredi M, Checcucci E, Fiori C, et al. Total anatomical reconstruction during robot-assisted radical prostatectomy: focus on urinary continence recovery and related complications after 1000 procedures. BJU Int. 2019.
Ginter E, Simko V. Global Prevalence and Future of Diabetes Mellitus. In: Ahmad SI, ed. Diabetes: An Old Disease, a New Insight. New York, NY: Springer New York; 2013:35-41.
Haga N, Yanagida T, Yabe M, et al. Timing of Urinary Pad Exchanges Was the Most Important Factor Affecting Quality of Life in the Early Postoperative Period After Robot-Assisted Laparoscopic Radical Prostatectomy. J Endourol. 2015;29(9):1044-1051.
Kim JJ, Ha YS, Kim JH, et al. Independent predictors of recovery of continence 3 months after robot-assisted laparoscopic radical prostatectomy. J Endourol. 2012;26(10):1290-1295.
Kumar A, Samavedi S, Bates AS, et al. Continence outcomes of robot-assisted radical prostatectomy in patients with adverse urinary continence risk factors. BJU Int. 2015;116(5):764-770.
Walz J, Epstein JI, Ganzer R, et al. A Critical Analysis of the Current Knowledge of Surgical Anatomy of the Prostate Related to Optimisation of Cancer Control and Preservation of Continence and Erection in Candidates for Radical Prostatectomy: An Update. Eur Urol. 2016;70(2):301-311.
Lee JK, Assel M, Thong AE, et al. Unexpected Long-term Improvements in Urinary and Erectile Function in a Large Cohort of Men with Self-reported Outcomes Following Radical Prostatectomy. Eur Urol. 2015;68(5):899-905.
Basiri A, de la Rosette JJ, Tabatabaei S, Woo HH, Laguna MP, Shemshaki H. Comparison of retropubic, laparoscopic and robotic radical prostatectomy: who is the winner? World J Urol. 2018;36(4):609-621.
Ficarra V, Novara G, Rosen RC, et al. Systematic review and meta-analysis of studies reporting urinary continence recovery after robot-assisted radical prostatectomy. Eur Urol. 2012;62(3):405-417.
Rocco F, Carmignani L, Acquati P, et al. Restoration of Posterior Aspect of Rhabdosphincter Shortens Continence Time After Radical Retropubic Prostatectomy. Journal of Urology. 2006;175(6):2201-2206.
Coelho RF, Chauhan S, Orvieto MA, et al. Influence of modified posterior reconstruction of the rhabdosphincter on early recovery of continence and anastomotic leakage rates after robot-assisted radical prostatectomy. Eur Urol. 2011;59(1):72-80.
- Abstract Viewed: 0 times
- Just Accepted/5750 Downloaded: 0 times