The aim of our study is to evaluate the role of preoperative quality of life (QL) as a possible risk factor for post robotic assisted radical prostatectomy (RARP) urinary incontinence. The secondary aim is to evaluate the possible effect of preoperative QL on post RARP lower urinary tract symptoms (LUTS) and erectile dysfunction (ED).
Between 2012 and 2017, all patients undergoing RARP for prostate cancer were enrolled. Patient's demographic, clinical, and histological characteristics were recorded. ED, LUTS, urinary incontinence, and QL were evaluated at baseline and postoperatively at 3, 6, and 12 months. Incontinence was evaluated with the International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form questionnaire and QL with the EORTC QLQ-C30 global health score (QLQ-GHS). Multivariate logistic regression analysis was used to evaluate the risk of postoperative incontinence, moderate/severe incontinence, LUTS, and moderate/severe ED.
Overall 4,603 patients were enrolled. Incontinence rates at 3, 6, and 12 months were respectively 17%, 10%, and 8%. On multivariate analysis, QL was an independent predictor of early incontinence (QLQ-GHS:0.71, CI:0.59-0.86; P= 0.001), severe incontinence (QLQ-GHS:0.65, CI:0.49-0.97; P= 0.006), and LUTS (QLQ-GHS:0.48, CI:0.41-0.57; P= 0.001). Single center design may be considered a limitation.
In our study a comprehensive evaluation of preoperative patient's QL, assessed by the EORTC QLQ-C30 questionnaire, can predict the early and long-term moderate/severe incontinence risk in RARP treated patients. Further studies should confirm our results.
Urologic oncology. 2019 Jul 17 [Epub ahead of print]
Cosimo De Nunzio, Antonio Luigi Pastore, Riccardo Lombardo, Fabiana Cancrini, Antonio Carbone, Andrea Fuschi, Lorenzo Dutto, Andrea Tubaro, Joern Heinrich Witt
Department of Urology, "Sant'Andrea" Hospital, "La Sapienza" University, Rome, Italy. Electronic address: ., Department of Urology, Ospedale di Latina, Latina, Italy., Department of Urology, "Sant'Andrea" Hospital, "La Sapienza" University, Rome, Italy., St Antonius Hospital Gronau, Department of Urology, Pediatric Urology and Urological Oncology, Prostate Cancer Northwest, Gronau, Germany.