Introduction: Urinary incontinence following robot-assisted laparoscopic prostatectomy (RALP) affects one in five men. Further, low testosterone has been associated with lower urinary tract symptoms and incontinence in both men and women. The aim of this study is to determine whether endogenous testosterone (T) levels (low or normal) or testosterone therapy (TTh) have an impact on the incidence of incontinence following RALP. Methods: Utilizing diagnoses codes associated with RALP, 5129 patients were identified. We then retrospectively documented testosterone levels and continence status for each of these patients throughout the 10/1/2017 - 10/1/2022 observation period. The patient cohort was stratified into three groups: 1) eugonadal 2) hypogonadal and 3) patients on T therapy. Chi-squared analyses were used to determine associations between hypogonadism, eugonadism, TTh, and incontinence in patients who have undergone RALP. This work was completed on SPSS. Results: Of the men with normal serum T (n= 3972) who underwent RALP, 628 were found to have urinary incontinence (15.8 %) after one year. Of those men with hypogonadism who underwent RALP (n=656), 164 patients faced urinary incontinence (25.0%) after one year. Lastly, among the patients receiving TTh who had prostatectomies (n=501), 24 encountered incontinence (4.8%). There was a statistically significant difference of incontinence rates between the three patient populations (p < .00001). Conclusions: This study suggests that hypogonadal men undergoing RALP have an increased risk of urinary incontinence. These findings expand previously demonstrated associations between hypogonadism and less successful outcomes following oncologic genitourinary surgery. Further investigation of testosterone’s role in urinary continence following RALP may improve pre-operative evaluation and counseling as well as warrant new treatment paradigms for hypogonadal men with prostate cancer. SOURCE OF Funding: None.
