A Decade of Urinary and Sexual Function Outcomes: Statewide Trends and Predictors of Urinary Continence and Erectile Function Recovery Following Robotic Radical Prostatectomy Over the Past Decade

Document Type

Conference Proceeding

Publication Date

5-2026

Publication Title

Journal of Urology

Abstract

NTRODUCTION AND OBJECTIVES: Robotic radical prostatectomy (RP) is a standard of care treatment option for localized prostate cancer, but postoperative urinary incontinence and erectile dysfunction significantly impact patient quality of life. Despite efforts to mitigate these effects, trends in recovery of continence and sexual function over the past decade remain unclear. This study evaluates these trends and factors influencing recovery post-RP using statewide data from the Michigan Urologic Surgery Improvement Collaborative (MUSIC). METHODS: We analyzed patient-reported outcomes (PRO) on urinary and sexual function for men undergoing RP from 2014-2024 in the MUSIC prostate cancer registry and included men with good baseline function. Social continence (SC) was defined as using 0-1pads per day, and good sexual function (SF) was defined as erections firm enough for penetration. To assess changes over time, we compared proportions of patients with recovery of SC and good SF at 3, 6, 12, and 24 months postoperatively across the study period. Multivariable generalized estimating equations models were also used to identify factors associated with recovery of SC and SF. RESULTS: There were 7,922 men with baseline SC and 3,507men with good baseline SF, thus forming the primary two cohorts of our study. At 3, 6, 12, and 24 months, SC was regained in 65%, 84%, 90% and 92% of men, respectively. However, good baseline SF was only recovered in 13%, 17%, 26% and 34% of men at the same time intervals (Figure). We did not appreciate a significant change in SC or SF since 2014 (OR=0.95 per 5 years, p=0.3; and OR=0.94 per 5 years, p=0.5; respectively). Compared to no nerve sparing, bilateral nerve sparing was associated with better SC recovery (OR = 1.43, p< 0.001),while both unilateral (OR = 1.71, p = 0.007) and bilateral nerve sparing (OR = 2.79, p< 0.001) were associated with SF recovery. Higher T-stage was associated with poorer SF recovery: T3a (OR = 0.80, p< 0.017) and T3b (OR = 0.61, p = 0.008) compared with T2 disease. T- stage was not associated with SC recovery (group p=0.5). CONCLUSIONS: Despite efforts to improve SC and SF following RP, rates of recovery have not changed significantly over the past decade. Patients with SC have very high rates of recovery even by6 months, but SF recovery has remained much more modest, even with those that have good baseline function.

Volume

215

Issue

5S

First Page

e647

Last Page

e647

Comments

American Urological Association Annual Meeting, May 15-18, 2026, Washington, DC

DOI

10.1097/01.JU.0001191456.93136.76.11

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