尿失禁常常在攝護腺根除術後一年內發生，過去有許多研究探討相關術後尿失禁的因子，其中包括年紀、膜尿道長度Membranous Urethral Length (MUL)、身體質量指數Body Mass Index(BMI)、術前下泌尿道症狀、攝護腺體積、共病指標 Charlson Comorbidity Index (CCI)、術前攝護腺特異抗原指數 Prostate Specific Antigen (PSA)、格里森分數及臨床期別，然而目前對於那些因子會增加尿失禁還沒有明確的答案。這篇系統性及統合性之回顧的論文分析了119篇論文(其中包括5篇隨機對照試驗、24篇前瞻性研究、88篇回溯性研究及2篇病例對照研究)共131379位病人，結果顯示年紀越大、膜尿道長度 (MUL)越短、攝護腺體積越大在攝護腺根除術術後3個月內以及3-12個月r皆較容易造成術後尿失禁，而共病指標 (CCI)分數越高則是只有在攝護腺根除術術後3個月內容易造成尿失禁，術後3-12個月並不顯著。其他因子如BMI、術前下泌尿道症狀、PSA、格里森分數及臨床期別並不會增加術後尿失禁的機率。

因此，除了病人本身的年紀與共病以外，可以透過術前核磁共振測量膜尿道長度和攝護腺體積，在術前與病人討論攝護腺根除術時，向病人解釋術後尿失禁的風險，讓醫師與病人一同找出最好的治療方針。

Context: While urinary incontinence (UI) commonly occurs after radical prostatectomy (RP), it is unclear what factors increase the risk of UI development.

Objective: To perform a systematic review of patient- and tumour-related prognosticfactors for post-RP UI. The primary outcome was UI within 3 mo after RP. Secondaryoutcomes included UI at 3–12 mo and 12 mo after RP. Evidence acquisition: Databases including Medline, EMBASE, and CENTRAL were searched between January 1990 and May 2020. All studies reporting patient- and tumour-related prognostic factors in univariable or multivariable analyses wereincluded. Surgical factors were excluded. Risk of bias (RoB) and confounding assessments were performed using the Quality In Prognosis Studies (QUIPS) tool. Randomeffects meta-analyses were performed for all prognostic factor, where possible.

Evidence synthesis: A total of 119 studies (5 randomised controlled trials, 24 prospective,88 retrospective, and 2 case-control studies) with 131 379 patients were included. RoB was high for study participation and confounding; moderate to high for statistical analysis, study attrition, and prognostic factor measurement; and low for outcome measurements. Significant prognostic factors for postoperative UI within 3 mo after RPwere age (odds ratio [OR] per yearly increase 1.04, 95% confidence interval [CI] 1.03–1.05), membranous urethral length (MUL; OR per 1-mm increase 0.81, 95% CI 0.74–0.88),prostate volume (PV; OR per 1-ml increase 1.005, 95% CI 1.000–1.011), and Charlson comorbidity index (CCI; OR 1.28, 95% CI 1.09–1.50).

Conclusions: Increasing age, shorter MUL, greater PV, and higher CCI are independent prognostic factors for UI within 3 mo after RP, with all except CCI remaining prognostic at 3–12 mo.

Patient summary: We reviewed the literature to identify patient and disease factors associated with urinary incontinence after surgery for prostate cancer. We found increasing age, larger prostate volume, shorter length of a section of the urethra (membranous urethra), and lower fitness were associated with worse urinary incontinence for the first 3 mo after surgery, with all except lower fitness remaining predictive at 3–12 mo