Influence of secondary diagnoses in the development of urinary incontinence after radical prostatectomy (original) (raw)

Post-Prostatectomy Urinary Incontinence: A Confluence of 3 Factors

Journal of Urology, 2010

Purpose: Urinary incontinence has a significant impact on the quality of life of patients who undergo radical prostatectomy for prostate cancer. We reviewed available published data to analyze the etiology and prevention of this surgical complication. Materials and Methods: A MEDLINE® search of the literature on this topic was performed. Results: There was a wide disparity in the reported rates of urinary incontinence after radical prostatectomy due to various reasons including definitions, patient selection and intraoperative technical factors. Conclusions: Postoperative urinary incontinence has a major impact on patient satisfaction after radical prostatectomy. Attention to factors including patient selection, nuances of the surgical technique, and a more uniform, widespread agreement on the definition and instruments to measure postoperative incontinence is needed to enhance surgical outcomes. In addition, further research is needed to improve the diagnosis and treatment of urinary incontinence after prostate cancer surgery.

Patient and tumour-related factors for prediction of urinary incontinence after radical prostatectomy

Scandinavian journal of urology, 2013

The aim of this study was to identify preoperative patient and tumour-related factors associated with 12 months postoperative urinary incontinence. In total, 1529 men who had undergone radical prostatectomy for clinically localized prostate cancer between September 2008 and February 2010 at 15 Swedish hospitals completed a questionnaire before, 3 and 12 months after surgery. Urinary leakage, comorbidity and possible confounders were measured by self-administered validated questionnaires. Clinical data were collected preoperatively and postoperatively. The primary outcome, incontinence, was defined as the change of one pad or more per day. The ratio of proportions, estimated according to the log-binomial regression model, was analysed for 38 different factors and is presented as relative risks with 95% confidence intervals. Age-adjusted relative risk was calculated in the corresponding bivariate regression model. Results. Prospective data were available from 1360 men (response rate 8...

Late-onset incontinence in a cohort of radical prostatectomy patients

International Journal of Urology, 2011

A cohort of 235 subjects, who underwent radical prostatectomy from 1994 to 2002, completely continent at the 2-year follow up and with the last follow-up visit in 2009, was examined to assess incidence and risk factors of late-onset incontinence. Median follow up was 100 months, range 84-176. At the last follow-up visit, 209 (89%) maintained continence, and 26 (11%) became incontinent. Specifically 14 out of 26 (6%) used one pad and 12 (5%) used two or more pads daily. Incidence of age Ն65 years at radical prostatectomy was greater in the subgroup who developed late incontinence, 109/209 (52%) vs 19/26 (73%). Incidence of adjuvant or salvage radiotherapy, of hormonal manipulation and of extraprostatic disease was similar in the two subgroups. Univariate and multivariate analysis did not disclose any difference. Late-onset incontinence is to be expected in about 10% of subjects who became completely continent after radical prostatectomy. The cause is likely to be related to ageing. Patients should be informed about the long-term risk of becoming incontinent.

The prevalence of urinary incontinence following radical prostatectomy and its related factors: A national registry based study

Men's health journal, 2020

Introduction: The purpose of this paper is to evaluate the prevalence and the risk factors of urinary incontinence following radical prostatectomy in Iranian population. This study is conducted based on the available data from the National Cancer Registry. Materials and Methods: In this retrospective study, we extracted the information of all the patients with organ-confined prostate cancer who underwent radical prostatectomy from 2010 to 2014. All the patients were interviewed face to face or via telephone to collect additional data. Urinary incontinence was evaluated by a questionnaire using the definition based on pads use. The effects of risk factors were evaluated using logistic regression models. Results: The details of 13,583 registered patients with prostate cancer were collected. Overall, the prevalence of urinary incontinence was estimated as 10.5% (n=1424). It is important to mention that the highest proportion of cases with urinary incontinence belonged to the age group ...

Urinary Incontinence and Urodynamic Evaluation of Patients Undergoing Radical Prostatectomy for Localized Prostate Cancer

2004

Urinary incontinence after prostatectomy is a common problem. The literature on urinary incontinence following rrealment for localized prostate cancer is reviewed. Special focus is placed on the rate of urinary incontinence following different modes of therapy, the effect of post-treatment urinary inconrinence on parienrs' qualiry of life, and the success of different methods used to treat the inconci nence. Good patient communication can also help improve the qualiry of life in the early post-treatment period.

Preoperative and operative factors to predict incontinence, impotence and stricture after radical prostatectomy

Prostate Cancer and Prostatic Diseases, 1998

The purpose of this study was to determine the incidence of patient-self reported post prostatectomy incontinence, impotence, bladder neck contracture or stricture, better, same or worse quality of life and willingness for same treatment again in a large group of radical prostatectomy (RP) patients and to determine if these morbidities are predictable with demographic, surgical or prostate cancer (PC) factors. Methods: A patient self-reporting questionnaire was completed and returned by 374 out of 458 eligible (81.7%) RP patients from one center, 267 (72.2%) have been operated since 1990 and all of whom were a minimum six month postoperative (75%b1 y). Questionnaire results were independently analyzed by a third party and correlated to demographic, operative, and tumor factors in an ongoing comprehensive PC database. Results: The patient self-reported incidence of post prostatectomy incontinence (any degree), impotence, and bladder neck contracture or stricture was 72.2, 87.4, and 25.9%, respectively. The reported rate of incontinence requiring protection was 39.0% and only 2.4% had persistent bladder neck contracture/stricture. Pathologic stage (continuous variable) was the only factor to signi®cantly predict incontinence and no factor could predict impotence or bladder neck contracture/ stricture in univariate analysis. No factor was predictive of morbidity by multivariate analysis. Despite incontinence and impotence signi®cantly affecting QOL self-reporting (P 0.001, 0.001, respectively) and willingness to undergo RP again (P 0.001, 0.067, respectively), the majority of patients would choose surgery again. Conclusions: Although radical prostatectomy morbidity is common and affects patient-reported overall QOL, most patients would choose the same treatment again. Demographic, preoperative, operative, and tumor factors did not reliably predict patient-reported morbidity in this series.