Prognostic Value of One-Month Postoperative ICIQ-SF Score for Six-Month Urinary Continence After Robot-Assisted Radical Prostatectomy

Background/Objectives: Urinary incontinence after radical prostatectomy remains a significant concern affecting postoperative quality of life. This study aimed to investigate whether the early postoperative International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) score is associated with mid-term urinary continence outcomes, using a patient-reported outcome approach. Methods: We retrospectively analyzed patients who underwent robot-assisted radical prostatectomy between May 2020 and July 2023 at the International University of Health and Welfare Narita Hospital and completed follow-up at one and six months postoperatively. Urinary incontinence severity was assessed using the ICIQ-SF (range 0–21, with higher scores indicating more severe symptoms). The primary outcome was incontinence at 6 months, defined as any pad use. Multivariable logistic regression and exploratory receiver operating characteristic (ROC) analyses were performed. Results: A total of 74 patients with complete follow-up data at both time points were included in the analysis. The ICIQ-SF score at one month was significantly associated with urinary incontinence at six months in both univariable and multivariable analyses. In the adjusted model, a higher one-month ICIQ-SF score independently predicted urinary incontinence at six months (odds ratio 1.15; 95% confidence interval 1.04–1.27; p = 0.005). Age, body mass index, and nerve-sparing status were not significantly associated with incontinence at six months. Exploratory ROC analysis demonstrated acceptable discriminative ability (area under the curve (AUC) 0.74, 95% confidence interval (CI) 0.61–0.87). A cut-off value of 13 yielded a sensitivity of 76.9% and a specificity of 59.1%. Conclusions: The ICIQ-SF score assessed one month after radical prostatectomy significantly predicts persistent urinary incontinence at six months. Early postoperative ICIQ-SF assessment may help identify patients at higher risk of persistent urinary incontinence. Further prospective studies are warranted to determine whether risk-stratified postoperative management based on early ICIQ-SF assessment improves clinical outcomes.