Objectives: Although urinary continence (UC) return post RARP can take up to two years, predictive metrics are required for patient counselling and early institution of enhanced rehabilitation. The aim was to evaluate to the accuracy of 3-month UC return as a predictive metric of long term UC recovery.

Method: A prospective cohort study of 740 men undergoing RARP over a 4 year period between September 2010 and Dec 2014 was conducted. The ICIQ-SF was administered pre and post RARP at 3, 6, 12, 18 and 24 months. Multiple linear regression analysis was used to test association between UC scores at different time points.

Results: 61.5% (276/449), 71.0% (282/397), 78.2% (248/317) and 83.3% (185/317) respectively were noted to be pad free at 3, 6, 12 and 18 months after surgery. Median ICIQ-SF scores at similar time points were 5, 4, 3 and 1. 98% of men were continent at 12 months if they required  ≤ 2 urinary pads at 3 months compared to only 14% that required ≥ 3 urinary pads (p=<0.001). Mean 12 month ICIQ-SF score for men requiring ≥3 pads at 3 months was 8 (SD 2.04) compared to 3 (SD 2.2) for patients requiring ≤ 2 pads (OR 2.7, 95% CI 2.1-3.5, p<0.001).

Conclusions: 3-month UC is a good predictor of long term UC return. A high proportion of patients requiring ≥ 3 pads at 3 months will not regain continence and can be identified as requiring enhanced rehabilitation.