Monocyte Chemotactic Protein-1 (MCP-1) as a Predictor of Prolonged Urinary Incontinence After Radical Prostatectomy
Michael A. Liss1, *, Thomas E. Ahlering2, Blanca Morales2, Adam Gordon2, Kathryn Osann3, Douglas Skarecky2, Achim Lusch2, Frank Zaldivar4, Gamal M. Ghoniem2
1 Department of Urology, University of Texas Health Science Center San Antonio, TX, USA
2 Department of Urology, University of California-Irvine, CA, USA
3 Department of Medicine, University of California-Irvine, CA, USA
4 Institute for Clinical and Translational Science, University of California-Irvine, CA, USA
To investigate monocyte chemotactic protein-1 (MCP-1) as a novel urinary biomarker to predict prolonged post prostatectomy incontinence.
Men submitted urine samples prior to robotic radical prostatectomy. MCP-1 values were derived using an ELISA test. Pad usage at 7, 30, and 60 days were documented by patient post cards mailed when zero pads was reached. The primary outcome was defined as no incontinence pad usage at 30 days at prostatectomy.
After exclusions, 76 patients were included in analyses. Continence was reached by 29% (22/76), 56% (42/76), and (75/76) 98% at 7, 30, and 60 days, respectively. The average MCP-1 (p=0.258) was not different between the continent and incontinent groups. Highest quartile of MCP-1 (MCP > 166 pg/mL) and normalized MCP-1 (MCP-1/TV >0.53) noted a significant delay in continence at 30 days (p=0.050 and p=0.003). Only 26% (5/19) in the highest MCP1/TV quartile were continent, whereas 65% (37/57) of men in the 3 lower quartiles reached zero pad continence (p=0.003). In a logistic regression model the highest quartile of MCP1/TV had a significant chance of being incontinent at 30 days (OR 0.22; 95% CI 0.058-0.80; p=0.022).
MCP-1/TV is a urinary biomarker that may predict prolonged urinary incontinence after radical prostatectomy.
Keywords: Incontinence, overactive bladder, prostate cancer, prostatectomy, quality of life.
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