PURPOSE: Urinary incontinence is a frequent complication of radical prostatectomy (RP) with a detrimental impact on quality of life.
Our objective was to identify predictors and trends in the use of procedures for post-prostatectomy incontinence (PPI).
MATERIALS AND METHODS: Using Surveillance, Epidemiology, and End Results (SEER) cancer registry data linked with Medicare claims, we identified men ≥ 66 years who had RP in 2000-2007. The primary outcome was use of an incontinence procedure. Demographic and clinical predictors of incontinence surgery were evaluated in multivariable regression analysis.
RESULTS: Of 16,348 men who had RP, 1,057 (6%) had at least one incontinence procedure at a median time of 20 months after RP, and 61% of these men had their first incontinence procedure within two years of RP. Older age and residence in the South were associated with greater probability of an incontinence procedure. Black men and those living in non-metropolitan areas were less likely than their peers to have an incontinence procedure. Fifteen percent of men who had any incontinence procedure had more than one type of procedure. Thirty-nine percent of men who received bulking agents also had a urethral sling or artificial urinary sphincter (AUS), and 13% of men receiving a sling also had an AUS. For 34% of those receiving any incontinence surgery, AUS placement was the only procedure performed.
CONCLUSIONS: In this population-based cohort of older men with prostate cancer, only 6% had an incontinence procedure following prostatectomy. This low rate may reflect underuse of potentially beneficial procedures.
Written by:
Kim PH, Pinheiro LC, Atoria CL, Eastham JA, Sandhu JS, Elkin EB. Are you the author?
Urology Service, Department of Surgery, Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan-Kettering Cancer Center, New York, NY.
Reference: J Urol. 2012 Sep 24. pii: S0022-5347(12)04956-7.
doi: 10.1016/j.juro.2012.08.246
PubMed Abstract
PMID: 23017528
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