Association of the G8 score with urinary continence recovery after robot-assisted radical prostatectomy

TL;DR

This study shows that a preoperative G8 frailty score is linked to better urinary continence recovery after robot-assisted prostate surgery.

Contribution

The study demonstrates that the G8 score can predict continence recovery, aiding preoperative counseling and planning.

Findings

Low frailty (G8 score >14) was significantly associated with better continence recovery at 3 months and 1 year post-surgery.

Nerve-sparing and younger age were also significant predictors of continence recovery.

Low-frailty patients showed better long-term continence outcomes, especially in non-nerve-sparing cases.

Abstract

To examine the association between the preoperative G8 score and urinary continence recovery after robot-assisted radical prostatectomy (RARP).

This study included 1794 patients enrolled in SUPER-PC-RP prospective cohort who underwent RARP and completed G8 questionnaire preoperatively. Patients were classified into high (G8 score ≤ 14) and low (G8 score > 14) frailty groups. Continence recovery, defined as the use of less than one pad per day, was assessed three months and one year postoperatively. Factors affecting continence recovery were identified using multivariable logistic analysis. Kaplan-Meier analysis evaluated continence recovery over two years according to frailty and nerve-sparing status.

Overall, 649 and 1145 patients were assigned to high- and low-frailty groups, respectively. At three months, continence group was significantly younger and had a lower prevalence of diabetes, lower International Society of Urological Pathology grade, lower pathological T stage, higher nerve-sparing rate, and lower frailty than incontinence group. At one year, patients who recovered continence were younger and had a higher nerve-sparing rate and lower frailty. Multivariable analysis showed age (3-month odds ratio (OR) 0.973, 1-year OR 0.947), nerve-sparing (3-month OR 2.39, 1-year OR 1.77), and low frailty (3-month OR 1.56, 1-year OR 1.75) as significant factors affecting continence recovery (all P < 0.05). In cumulative Kaplan-Meier analysis, low-frailty group showed better continence recovery than high-frailty group, with a greater difference observed in non-nerve-sparing group (P < 0.001).

Frailty assessment using G8 questionnaire is associated with urinary continence recovery after RARP, which provides an advantage for preoperative patient counseling and surgical planning.

The online version contains supplementary material available at 10.1007/s00345-026-06221-7.

Figures