Cancer - Prostate(구연) (E-119) 근치적 전립선 절제술에서 술 후 요실금의 회복을 예측하는데 있어서 술 후 막요도 길이의 중요성 아주대학교 의과대학 비뇨의학과교실, ¹분당제생병원 비뇨의학과교실 유희재, 박성곤, 심강희, 조대성¹, 추설호, 김선일, 최종보, 안현수, 김세중 Background and Objectives: To analyze the potential surgical factors affecting post-operative urinary continence (UC), including postoperative membranous urethral length (MUL), in an era where open radical prostatectomy (ORP) and robot-assisted radical prostatectomy (RARP) coexist. Materials and Methods: Consecutive patients undergoing either ORP or RARP by a single surgeon between April 2009 and June 2017 were included in this study. Pericatheter urethrography (PCU) was performed the day of catheter removal to confirm healing of the vesicourethral anastomosis and to measure PCU-MUL. Daily usage of incontinence pad was self-reported by the patient at each post-operative visit through a questionnaire. Univariate and multivariate analyses were performed to identify factors that influenced recovery of UC. Results: Of the 196 patients included, 121 and 75 patients received ORP and RARP, respectively. Compared to the ORP group, the RARP group was associated with significantly younger age, clinically less-advanced disease, better neurovascular bundle (NVB) preservation and longer PCU-MUL. However, MUL measured by pre-operative magnetic resonance imaging (MRI-MUL) did not differ between the two groups. The cumulative full UC rates (0 pad/day) at 1 year in the ORP and RARP groups were 87% and 95%, respectively. In the univariate analysis, older age, high preoperative IPSS irritative symptom domain, ORP, poorer NVB preservation, and shorter PCU-MUL, but not MRI-MUL were associated with delayed recovery of full UC. In the multivariate analysis, only older age, high preoperative IPSS irritative symptom domain and shorter PCU-MUL remained as independent factors significantly associated with delayed recovery of full UC. Conclusion: Our study highlights the importance of saving the MUL as long as possible in terms of UC recovery. This holds true for ORP even in the era of RARP and surgeons should not simply give up the prospect of early UC in exchange for the patient’s choice of ORP instead of RARP. keywords : Radical prostatectomy, postoperative membranous urethra length, postoperative incontinence