BACKGROUND: Urinary incontinence is a common short-term complication of radical prostatectomy (RP).
Little is known about the long-term impact of RP on continence.
OBJECTIVE: To elucidate the long-term progression of continence after RP.
DESIGN, SETTING, AND PARTICIPANTS: From October 2000 through September 2012, 1788 men undergoing open RP for clinically localized prostate cancer by a single surgeon at an urban tertiary care center prospectively signed consent to be followed before RP and at 3, 6, 12, 24, 96, and 120 mo after RP. A consecutive sampling method was used and all men were included in this study.
INTERVENTION: Men underwent open RP.
OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Regression models controlled for preoperative University of California, Los Angeles-Prostate Cancer Index urinary function score (UCLA-PCI-UFS), age, prostate-specific antigen level, Gleason score, stage, nerve-sparing status, race, and marital status were used to evaluate the association of time since RP with two dependent variables: UCLA-PCI-UFS and continence status.
RESULTS AND LIMITATION: The mean UCLA-PCI-UFS declined between 2 yr and 8 yr (83.8 vs 81.8; p=0.007) and marginally between 8 yr and 10 yr (81.8 vs 79.6; p=0.036) after RP, whereas continence rate did not significantly change during these intervals. Men ≥60 yr old experienced a decline in mean UCLA-PCI-UFS between 2 yr and 8 yr (p=0.002) and a marginal decline in continence rate between 2 yr and 10 yr (p=0.047), whereas these variables did not change significantly in men < 60 yr old. These outcomes are for an experienced surgeon, so caution should be exercised in generalizing these results.
CONCLUSIONS: Between 2 yr and 10 yr after RP, there were slight decreases in mean UCLA-PCI-UFS and continence rates in this study. Men aged < 60 yr had better long-term outcomes. These results provide realistic long-term continence expectations for men undergoing RP.
Written by:
Prabhu V, Sivarajan G, Taksler GB, Laze J, Lepor H. Are you the author?
Department of Urology, New York University School of Medicine, New York, NY, USA.
Reference: Eur Urol. 2013 Aug 9. pii: S0302-2838(13)00827-0.
doi: 10.1016/j.eururo.2013.08.006
PubMed Abstract
PMID: 23957946
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