Diabetes mellitus lowers the chance of short-term urinary continence recovery in prostate cancer patients undergoing radical prostatectomy

Abstract

Introduction: the aim of this article was to test the impact of diabetes mellitus (DM) on short-term urinary continence in patients undergoing radical prostatectomy (RP). Material and methods: we relied on an institutional tertiary-care database to identify patients who underwent RP between 11/2018 and 02/2021 with data available on short-term urinary continence status (30–90 days post-surgery). Continence was defined as the usage of no or one safety-pad within 24 hours. Univariable and multivariable logistic regression models tested the correlation between DM and short-term continence. Covariates consisted of pathological T-stage, body mass index, prostate volume, surgical approach and nerve-sparing. Results: of 142 eligible patients, 15 (11%) patients exhibited concomitant DM. Patients diagnosed with DM exhibited lower continence rates at short-term follow-up compared to patients without DM (33 vs 63%, p = 0.03). In univariable and multivariable logistic regression models, DM was strongly associated with reduced chances of short-term urinary continence recovery (multivariable odds ratio [OR]: 0.26, 95%-CI: 0.07–0.86; p = 0.03). Furthermore, pathological T-stage (pT3/pT4) was additionally associated with reduced chance of urinary continence in logistic regression models (multivariable OR: 0.43, 95%-CI: 0.19–0.94; p = 0.04). Other covariables failed to reach statistical significance in multivariable logistic regression analyses predicting urinary continence. Conclusions: DM was associated with lower chances of short-term urinary continence recovery in a contemporary cohort of patients undergoing radical prostatectomy. Patients with DM should be preoperatively informed and intensified, postoperative pelvic floor training should be considered in this subgroup of RP patients.