Objective:

To create a predictive model for early urinary incontinence following laparoscopic radical prostatectomy (LRP).

Approach:

• Study Design: Retrospective analysis of clinical data from 408 patients who underwent LRP at Xiangyang Central Hospital from December 2020 to December 2025. Exclusion criteria included patients with a history of prostate surgery or urinary incontinence, lack of a preoperative MRI, need for preoperative catheterization due to urinary retention, receipt of neoadjuvant endocrine therapy or radiotherapy, or incomplete clinical data.

Key Findings:

• 41.2% of patients experienced urinary incontinence post-surgery.
• 58.8% of patients did not experience urinary incontinence post-surgery.
• Independent predictors identified include prostate volume, membranous urethral length (MUL), intravesical prostatic protrusion length (IPPL), and neurovascular bundle (NVB) preservation.
• The nomogram developed showed good predictive performance with an AUC of 0.910.

Interpretation:

The identified predictors have significant value in forecasting early urinary incontinence after LRP, and the nomogram demonstrates strong predictive capabilities.

Limitations:

• The study is retrospective and may be subject to selection bias.
• Exclusion criteria may limit the generalizability of the findings.

Conclusion:

The nomogram based on prostate volume, MUL, IPPL, and NVB preservation effectively predicts early urinary incontinence after LRP.