Urinary incontinence and use of incontinence surgery after radical prostatectomy: a national study using patient-reported outcomes

Matthew G Parry, Ted A Skolarus, Julie Nossiter, Arunan Sujenthiran, Melanie Morris, Thomas E Cowling, Brendan Berry, Ajay Aggarwal, Heather Payne, Paul Cathcart, Noel W Clarke, Jan van der Meulen

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)

Abstract

Objectives: To investigate whether patient‐reported urinary incontinence (UI) and bother scores after radical prostatectomy (RP) result in subsequent intervention with UI surgery. Patients and Methods: Men diagnosed with prostate cancer in the English National Health Service between April 2014 and January 2016 were identified. Administrative data were used to identify men who had undergone a RP and those who subsequently underwent a UI procedure. The National Prostate Cancer Audit database was used to identify men who had also completed a post‐treatment survey. These surveys included the Expanded Prostate Cancer Composite Index (EPIC‐26). The frequency of subsequent UI procedures, within 6 months of the survey, was explored according to EPIC‐26 UI scores. The relationship between ‘good’ (≥75) or ‘bad’ (≤25) EPIC‐26 UI scores and perceptions of urinary bother was also explored (responses ranging from ‘no problem’ to ‘big problem’ with respect to their urinary function). Results: We identified 11 290 men who had undergone a RP. The 3‐year cumulative incidence of UI surgery was 2.5%. After exclusions, we identified 5165 men who had also completed a post‐treatment survey after a median time of 19 months (response rate 74%). A total of 481 men (9.3%) reported a ‘bad’ UI score and 207 men (4.0%) also reported that they had a big problem with their urinary function. In all, 47 men went on to have UI surgery within 6 months of survey completion (0.9%), of whom 93.6% had a bad UI score. Of the 71 men with the worst UI score (zero), only 11 men (15.5%) subsequently had UI surgery. Conclusion: In England, there is a significant number of men living with severe, bothersome UI after RP, and an unmet clinical need for UI surgery. The systematic collection of patient‐reported outcomes could be used to identify men who may benefit from UI surgery.
Original languageEnglish
Pages (from-to)84-91
Number of pages8
JournalBJU International
Volume130
Issue number1
Early online date6 Jan 2022
DOIs
Publication statusPublished - Jul 2022

Keywords

  • patient-reported outcomes
  • incontinence surgery
  • radical prostatectomy
  • post prostatectomy incontinence
  • national prostate cancer audit
  • prostate cancer
  • urinary incontinence

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