Latency of Bulbocavernosus Reflex Predicts Short-term Urinary Incontinence Severity after Robot-assisted Radical Prostatectomy

Abstract

Prostate cancer remains a leading cause of morbidity in men, with radical prostatectomy often resulting in postoperative urinary incontinence (UI). This study aimed to identify predictors of UI severity following robot-assisted radical prostatectomy (RARP) using pelvic floor electromyography (EMG) and clinical parameters. A retrospective analysis was conducted on 68 prostate cancer patients who underwent RARP by a single surgeon. Preoperative pelvic floor EMG and the International Consultation on Incontinence Questionnaire–Short Form (ICI-Q-SF) were administered, with postoperative ICI-Q-SF scores assessed at one month. Patients were stratified into low-severity (ICI-Q-SF <8, n=25) and high-severity (ICI-Q-SF ≥8, n=43) UI groups. Age, neurovascular bundle sparing, and bulbocavernosus reflex (BCR) latency differed significantly between groups. Multivariate analysis revealed age and BCR latency as independent predictors of UI severity (areas under the curves (AUC)=0.755, sensitivity=0.721, specificity=0.720). These findings suggest that preoperative BCR latency and age may serve as biomarkers for postoperative UI severity, facilitating personalized risk assessment.