{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T21:59:09Z","timestamp":1770501549842,"version":"3.49.0"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,1,10]],"date-time":"2022-01-10T00:00:00Z","timestamp":1641772800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p><jats:bold>Introduction:<\/jats:bold> Urinary incontinence (UI) is a wide-spread and feared side-effect of conventional or even robot-assisted laparoscopic prostatectomy (RALP) due to its high impact on patients' quality of life (QoL). Non-modifiable risk factors for UI have already been identified \u2013 on surgical and patient side. Yet, to our knowledge, focus thus far has not been placed on functional aspects regarding general cognitive ability.<\/jats:p><jats:p><jats:bold>Materials and Methods:<\/jats:bold> This is an observational single-center, prospective, double-blinded evaluation of 109 RALPs performed between 07\/2020 and 03\/2021. All patients underwent a Mini Mental State Examination (MMSE) prior to surgery to evaluate their cognitive ability. Early post-prostatectomy incontinence (PPI) was evaluated using a standardized 1 h pad test performed 24 h after removal of the urinary catheter. The association between MMSE results and PPI were evaluated using univariate and multivariate logistic regression models.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Multivariate logistic regression analyses identified MMSE results and nerve sparing (NS) as independent predictors for PPI in patients with an intermediate MMSE result (25\u201327 points) having a 3.17 times higher risk of PPI when compared to patients with a good MMSE result (\u226528) (95% Confidence Interval (CI): 1.22\u20139.06, <jats:italic>p<\/jats:italic> = 0.023), while patients without NS had a 3.53 times higher risk of PPI when compared to patients with NS (95% CI: 1.54\u201311.09, <jats:italic>p<\/jats:italic> = 0.006).<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> A lower cognitive ability should be treated as a non-modifiable risk-factor for early PPI. In the future it could find its place as a clinical screening tool to identify patients who require more attention especially in the pre-, but also in the postoperative phase.<\/jats:p>","DOI":"10.3389\/fsurg.2021.812197","type":"journal-article","created":{"date-parts":[[2022,1,10]],"date-time":"2022-01-10T04:48:16Z","timestamp":1641790096000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Cognitive Ability as a Non-modifiable Risk Factor for Post-prostatectomy Urinary Incontinence: A Double-Blinded, Prospective, Single-Center Trial"],"prefix":"10.3389","volume":"8","author":[{"given":"Mathias","family":"Reichert","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ionel Valentin","family":"Popeneciu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annemarie","family":"Uhlig","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lutz","family":"Trojan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirjam Naomi","family":"Mohr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,1,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1188\/03.ONF.229-238","article-title":"Incontinence after prostatectomy: coping with incontinence after prostate cancer surgery","volume":"30","author":"Palmer","year":"2003","journal-title":"Oncol Nurs Forum."},{"key":"B2","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1038\/s41585-021-00445-5","article-title":"Preoperative exercise interventions to optimize continence outcomes following radical prostatectomy","volume":"18","author":"Mungovan","year":"2021","journal-title":"Nat Rev Urol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1111\/j.1464-410X.2004.04951.x","article-title":"Open versus laparoscopic radical prostatectomy: part II","volume":"94","author":"Salomon","year":"2004","journal-title":"BJU Int."},{"key":"B4","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1007\/s00345-003-0388-2","article-title":"Prospective predictors of urinary continence after anatomical radical retropubic prostatectomy: a multivariate analysis","volume":"22","author":"Oefelein","year":"2004","journal-title":"World J Urol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1159\/000030216","article-title":"Prediction of urinary continence following radical prostatectomy","volume":"60","author":"Van Kampen","year":"1998","journal-title":"Urol Int."},{"key":"B6","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1177\/0300060517715396","article-title":"Predictors of short-term and long-term incontinence after robot-assisted radical prostatectomy","volume":"46","author":"Shao","year":"2017","journal-title":"J Int Med Res"},{"key":"B7","doi-asserted-by":"publisher","first-page":"786","DOI":"10.4103\/1119-3077.163274","article-title":"Mini-mental state exam versus montreal cognitive assessment in patients with diabetic retinopathy","volume":"18","author":"Ogurel","year":"2015","journal-title":"Niger J Clin Pract."},{"key":"B8","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1161\/CIRCOUTCOMES.109.884171","article-title":"Cognitive function and anticoagulation control in patients with atrial fibrillation","volume":"3","author":"Flaker","year":"2010","journal-title":"Cir Cardiovasc Qual And Outc."},{"key":"B9","unstructured":"EAU guidelines prostate cancer\n            MottetN\n            CornfordP\n            van den BerghRCN\n            BriersE\n            De SantisM\n            GillessenS\n          ArnhemEAU Guidelines OfficeEdn. 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