{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:18:38Z","timestamp":1787242718214,"version":"build-2736575974"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":49,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Urinary incontinence can affect up to 53% of patients after radical prostatectomy, yet prediction tools rely on binary outcomes, missing heterogeneous recovery patterns. We developed machine-learning models that for the first time predict incontinence presence, severity, and quality-of-life impact at 3 and 12\u00a0months post-surgery. XGBoost models were trained on 21 perioperative features from 2,586 patients (2018\u20132021) and validated on 728 patients (2022). For patients incontinent at 3\u00a0months (n\u2009=\u2009962), 12-month predictions achieved strong performance (AUC 0.82\u20130.86), with early quality-of-life impact (SHAP 1.4) outperforming symptom severity (SHAP 1.0) as a predictor. Three-month predictions using only baseline features showed moderate performance (AUC 0.52\u20130.59). Patients with identical total ICIQ-UI scores demonstrated divergent recovery trajectories when symptom severity and quality-of-life components were analyzed separately, with some achieving continence while others remained severely affected. Decomposing outcomes into multidimensional components rather than using aggregate scores enables personalized prediction of continence recovery, facilitating targeted counseling and rehabilitation strategies.<\/jats:p>","DOI":"10.1038\/s41598-026-51301-8","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T15:05:11Z","timestamp":1779721511000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["AI based prediction of post prostatectomy urinary incontinence and its impact on quality of life: development and validation study"],"prefix":"10.1038","volume":"16","author":[{"given":"Adamos","family":"Hadjivasiliou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand","family":"Kelkar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashwin","family":"Sridhar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg","family":"Shaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Collins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prasanna","family":"Sooriakumaran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Senthil","family":"Nathan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Briggs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D.","family":"Kelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zafer","family":"Tandogdu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivana","family":"Drobnjak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"51301_CR1","doi-asserted-by":"publisher","first-page":"e3131","DOI":"10.1590\/1518-8345.2757.3131","volume":"27","author":"MFVG Bernardes","year":"2019","unstructured":"Bernardes, M. F. V. G. et al. Impact of urinary incontinence on the quality of life of individuals undergoing radical prostatectomy. Rev. Lat. Am. Enfermagem. 27, e3131 (2019).","journal-title":"Rev. Lat. Am. Enfermagem."},{"issue":"1","key":"51301_CR2","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1111\/bju.12002","volume":"112","author":"LD Borregales","year":"2013","unstructured":"Borregales, L. D. et al. Trifecta\u2019after radical prostatectomy: Is there a standard definition?. BJU Int. 112(1), 60\u201367 (2013).","journal-title":"BJU Int."},{"issue":"5A","key":"51301_CR3","doi-asserted-by":"publisher","first-page":"E69","DOI":"10.1111\/bju.14566","volume":"123","author":"E Sacco","year":"2019","unstructured":"Sacco, E. et al. Patient pad count is a poor measure of urinary incontinence compared with 48-h pad test: Results of a large-scale multicentre study. BJU Int. 123(5A), E69\u2013E78 (2019).","journal-title":"BJU Int."},{"issue":"2","key":"51301_CR4","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1002\/jmrs.421","volume":"68","author":"H Nguyen","year":"2021","unstructured":"Nguyen, H., Butow, P., Dhillon, H. & Sundaresan, P. A review of the barriers to using patient-reported outcomes (PROs) and patient-reported outcome measures (PROMs) in routine cancer care. J. Med. Radiat. Sci. 68(2), 186\u2013195 (2021).","journal-title":"J. Med. Radiat. Sci."},{"issue":"7","key":"51301_CR5","doi-asserted-by":"publisher","first-page":"1644","DOI":"10.3390\/cancers14071644","volume":"14","author":"Ruben M Pinkhasov","year":"2022","unstructured":"Pinkhasov, Ruben M. et al. Prediction of incontinence after robot-assisted radical prostatectomy: development and validation of a 24-month incontinence nomo gram. Cancers 14(7), 1644 (2022).","journal-title":"Cancers"},{"issue":"1","key":"51301_CR6","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1186\/s12885-024-12850-1","volume":"24","author":"C Shen","year":"2024","unstructured":"Shen, C. et al. Nomogram predicting early urinary incontinence after radical prostatectomy. BMC Cancer 24(1), 1095 (2024).","journal-title":"BMC Cancer"},{"issue":"9","key":"51301_CR7","doi-asserted-by":"publisher","first-page":"e1861","DOI":"10.1002\/cnr2.1861","volume":"6","author":"W Nakamura","year":"2023","unstructured":"Nakamura, W. et al. Combination of deep learning and ensemble machine learning using intraoperative video images strongly predicts recovery of urinary continence after robot-assisted radical prostatectomy. Cancer Reports 6(9), e1861. https:\/\/doi.org\/10.1002\/cnr2.1861 (2023).","journal-title":"Cancer Reports"},{"key":"51301_CR8","doi-asserted-by":"publisher","first-page":"4350","DOI":"10.3390\/cancers14184350","volume":"14","author":"N d\u2019Altilia","year":"2022","unstructured":"d\u2019Altilia, N. et al. A matched-pair analysis after robotic and retropubic radical prostatectomy: a new definition of continence and the impact of different surgical techniques. Cancers 14, 4350. https:\/\/doi.org\/10.3390\/cancers14184350 (2022).","journal-title":"Cancers"},{"issue":"10","key":"51301_CR9","doi-asserted-by":"publisher","first-page":"e20337","DOI":"10.1016\/j.heliyon.2023.e20337","volume":"9","author":"J Li","year":"2023","unstructured":"Li, J. et al. An artificial intelligence method for predicting postoperative urinary incontinence based on multiple anatomic parameters of MRI. Heliyon 9(10), e20337. https:\/\/doi.org\/10.1016\/j.heliyon.2023.e20337 (2023).","journal-title":"Heliyon"},{"issue":"8","key":"51301_CR10","doi-asserted-by":"publisher","first-page":"871","DOI":"10.1089\/end.2024.0057","volume":"38","author":"D Amparore","year":"2024","unstructured":"Amparore, D. et al. Development of a machine learning algorithm to predict the risk of incontinence after robot-assisted radical prostatectomy. J. Endourol. 38(8), 871\u2013878. https:\/\/doi.org\/10.1089\/end.2024.0057 (2024).","journal-title":"J. Endourol."},{"issue":"1","key":"51301_CR11","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.eururo.2015.02.028","volume":"68","author":"P Cathcart","year":"2015","unstructured":"Cathcart, P. et al. Achieving quality assurance of prostate cancer surgery during reorganisation of cancer services. Eur. Urol. 68(1), 22\u201329 (2015).","journal-title":"Eur. Urol."},{"issue":"4","key":"51301_CR12","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1002\/nau.20041","volume":"23","author":"K Avery","year":"2004","unstructured":"Avery, K. et al. Iciq: A brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourol. Urodyn. 23(4), 322\u2013330 (2004).","journal-title":"Neurourol. Urodyn."},{"key":"51301_CR13","unstructured":"Iciq \u2014 the international consultation on incontinence questionnaire. https: \/\/iciq.net\/. (Accessed 30 August 2024)."},{"issue":"5","key":"51301_CR14","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1002\/nau.20674","volume":"28","author":"A Klovning","year":"2009","unstructured":"Klovning, A., Avery, K., Sandvik, H. & Hunskaar, S. Comparison of two questionnaires for assessing the severity of urinary incontinence: The ICIQ UI SF versus the Incontinence Severity Index. Neurourol. Urodyn. 28(5), 411\u2013415 (2009).","journal-title":"Neurourol. Urodyn."},{"issue":"7","key":"51301_CR15","first-page":"9090","volume":"12","author":"C Du","year":"2019","unstructured":"Du, C., Li, H., Qu, L., Li, Y. & Bao, X. Personalized nursing care improves psychological health, quality of life, and postoperative recovery of patients in the general surgery department. Int. J. Clin. Exp. Med. 12(7), 9090\u20139096 (2019).","journal-title":"Int. J. Clin. Exp. Med."},{"key":"51301_CR16","doi-asserted-by":"publisher","first-page":"1289765","DOI":"10.3389\/fsurg.2023.1289765","volume":"10","author":"Stamatios Katsimperis","year":"2023","unstructured":"Katsimperis, Stamatios et al. Surgical techniques to preserve continence after robot-assisted radical prostatectomy. Front. Surg. 10, 1289765 (2023).","journal-title":"Front. Surg."},{"key":"51301_CR17","unstructured":"Uroweb - European Association of Urology. (n.d.). EAU Guidelines on the Management of Non-neurogenic Male LUTS - INTRODUCTION - Uroweb. https:\/\/uroweb.org\/guidelines\/management-of-non-neurogenic-male-luts."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-51301-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-51301-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-51301-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T13:27:24Z","timestamp":1783949244000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-51301-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,25]]},"references-count":17,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["51301"],"URL":"https:\/\/doi.org\/10.1038\/s41598-026-51301-8","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,25]]},"assertion":[{"value":"11 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"21855"}}