To characterize the incidence of stress urinary incontinence (SUI) after radical prostatectomy (RP), its treatment, and impact on quality of life (QoL) and work status 1 year after RP.
Prostate cancer patients treated by RP (1998-2016) were selected from CaPSURE. SUI was defined as any pads per day (ppd) 1 year after RP. SUI procedures were tracked by CPT codes (sling and artificial sphincter). Patients reported work status (full-time, part-time, unpaid), UCLA PCa Index urinary function (UF) and bother (UB) and SF36 Index physical function (PF). Associations of incontinence with UF, UB and PF and work status changes were assessed (ANOVA). Lifetable estimates and Cox proportional hazards regression evaluated risk of undergoing SUI procedures.
664/2,989 (22%) men treated with RP reported SUI at 1 year. More men with SUI had ≥GG2, intermediate to high-risk disease and non-nerve sparing surgery (all p<0.01). Cumulative incidence of SUI procedures was 1.4% at 10 years after RP. Age (HR 2.68 per 10 years, 95% CI 1.41-5.08) and number of ppd at 1 year (HR 3.20, 95% CI 2.27-4.50) were associated with undergoing SUI procedures. UF declined at 1 year after RP, while UB and PF remained stable. UF, UB and PF were inversely associated with number of ppd (all p<0.01). Change in work status was not associated with incontinence or QoL scores.
Incontinence affected QoL without impacting work status, suggesting that men with SUI after RP may continue working and go under-treated despite impact on quality of life.
Urology. 2023 Jul 11 [Epub ahead of print]
A Braun, S L Washington, J E Cowan, L A Hampson, P R Carroll
Department of Urology, University of California, San Francisco, CA. Electronic address: ., Department of Urology, University of California, San Francisco, CA; Department of Epidemiology & Biostatistics, University of California, San Francisco, CA., Department of Urology, University of California, San Francisco, CA.