Does type 2 diabetes mellitus have an impact on postoperative early, mid-term and late-term urinary continence after robot-assisted radical prostatectomy?

Abstract

Objective: We evaluated the effect of diabetes mellitus (DM) on urinary continence after robotic radical prostatectomy (RARP). Patients and Methods: Overall, 99 patients with DM and 213 patients without DM who underwent RARP with at least 2-year follow-up were included. The preoperative prostate biopsy Gleason scores and clinical stages of the groups were similar. The patients who were dry or used one safety pad per day were regarded as continent. Early (0-3 months), mid-term (4-12 months), and late-term (>12 months) continence rates were evaluated. Results: In diabetic and nondiabetic groups, mean age was 63.36.5 and 61.3 +/- 6.8 years, respectively (p=0.015). On the day of the removal of the urethral catheter, 61.6% (n=61) of the diabetic patients and 99.1% (n=211) of the nondiabetic patients were continent (p=0.000). At third-month follow-up, 80.8% (n=80) of the diabetic patients and 99.1% (n=211) of the nondiabetic patients were continent (p=0.000). At sixth-month follow-up, 89.9% (n=89) of the diabetic patients and 99.1% (n=211) of the nondiabetic patients were continent (p=0.000). At first-year follow-up, 93.9% (n=93) of the diabetic patients and 100% (n=213) of the nondiabetic patients were continent (p=0.001). At 18th-month follow-up, 96.0% (n=95) of the diabetic patients and 100% (n=213) of the nondiabetic patients were continent (p=0.013). At second-year follow-up, 98.0% (n=97) of the diabetic patients and 100% (n=213) of the nondiabetic patients were continent (p=0.115). Multivariate analysis showed that age and body mass index had no impact on urinary continence (p>0.05). Presence of diabetes (p=0.008) and duration (5 years) of diabetes (p=0.004) were independent factors that had a significant negative impact on urinary continence. Conclusions: Diabetes seems to be a significant disadvantage in gaining urinary continence compared with nondiabetic patients particularly in the first 18 months after RARP. Diabetic patients should be informed about possible late recovery of postoperative urinary continence compared with nondiabetic patients after RARP.