To examine the incidence and factors associated with the development of new comorbidities in men undergoing anti-incontinence surgery after prostate cancer (PCa) surgery. Post-prostatectomy incontinence (PPI) may deter men from engaging in physical activities and increase the risk of developing comorbidities after prostatectomy.
Patients undergoing surgery for PPI from 2006-2019 were identified. A retrospective review was performed to document patient characteristics noted at the time of PCa surgery and compare these with parameters recorded at the time of anti-incontinence surgery.
A total of 229 patients were included. Mean age was 68.8 years at time of incontinence surgery. Median duration of incontinence was 3.5±4.6 years. There was a significant increase in CCI comorbidities between PCa surgery and PPI surgery (2.7±1.5 vs 4.1±1.9, p<0.0001). Almost half of patients (45.2%) developed a new comorbidity while awaiting incontinence surgery including an increase in the incidence of diabetes (21.9% vs. 12.7%; p<0.0001), hypertension (56.2% vs. 36.7%; p<0.0001), coronary artery disease (14.6% vs. 8.9%; p=0.008) and arrhythmia (11.0% vs. 3.8%; p=0.008). On multivariable analysis, duration of incontinence was significantly associated with development of new comorbidities (O.R. 1.2, p=0.01) while age (p=0.20) and incontinence severity (p=1.0) were not. There was no change in weight (p=0.34), obesity (p=1.0) or BMI (p=0.18) between PCa surgery and PPI surgery.
Patients with PPI appear at risk of developing new comorbidities while awaiting anti-incontinence surgery. Strategies which expedite return of continence e.g. early surgical intervention, may facilitate resumption of physical activity and minimise the risk of future comorbidity.
Urology. 2021 Oct 12 [Epub ahead of print]
Elaine J Redmond, R Christopher Doiron, Keith F Rourke
Division of Urology, University of Alberta, Edmonton, Alberta. Electronic address: ., Division of Urology, University of Alberta, Edmonton, Alberta. Electronic address: ., Division of Urology, University of Alberta, Edmonton, Alberta. Electronic address: .