(219) Prevalence of Sexual Incontinence in Men with Stress Urinary Incontinence After Radical Prostatectomy

Abstract

Abstract Introduction Sexual incontinence (SI) includes arousal incontinence and climacturia. SI is under-reported after radical prostatectomy (RP), significantly bothering the patient and the partner. Objective This study aimed to evaluate the prevalence of SI based on the SUI severity and identify predictors of SI during the first year after RP. Methods This study included men with RP and a follow-up until 1 year post-surgery. Patients who received ADT or radiation therapy either pre or post-RP were excluded. We performed a descriptive assessment of demographics, comorbidities, pre-RP prostate-specific antigen (PSA), Gleason group of the surgical pathology, nerve-sparing status (NSS), and erectile function (EF) based on the IIEF score. SI was defined as the presence or absence of climacturia or arousal incontinence reported by the patient at 3, 6, 9, and 12 months post-RP. SUI was described based on the number of pads used per day. These were categorized as 0 to 1 pad per day (No SUI or mild SUI), 2 pads per day (moderate SUI), and ≥ 3 pads per day (severe SUI) at 3, 6, and 12 months post-RP. We determined the prevalence of SI for each SUI category at each time period. We analyzed predictors of SI using a logistic regression model at 3, 6, 9, and 12 months post-RP. Factors entered into the model included: patient age, number of comorbidities (≥ 3, yes), NSS both resected (yes) and severe SUI (≥ 3 pads per day, yes). Results Our study included 2768 men with a median age of 60 (55-66). 11% had diabetes. 27% obstructive sleep apnea, and the median number of comorbidities was 1 (1-2). The median preoperative PSA was 5.6 ng/ml. The median Gleason grade group was 2 (2, 3). 71% had bilateral NSS, 22% unilateral, and 7% had both sides resected. The prevalence of SI was 26%, 24%, 23%, and 27% at 3, 6, 9, and 12 months post-RP, respectively. The prevalence of SI was higher among men with severe SUI compared to men with 0 to 1 pad per day at 6, 9, and 12 months post-RP. At 3 months, men with 0 to 1 pad per day reported 25% SI, vs. men with severe SUI described 28% SI. At 6 months, for men with no SUI/mild SUI, 19% described SI, vs. men with severe SUI, 32% had SI. At 9 months, for men with no SUI/mild SUI, 20% described SI vs. men with severe SUI, 33% had SI. And at 12 months, men with 0 to 1 pad per day reported 23% SI, vs. men with severe SUI described 36% SI. On the logistic regression model, severe SUI ≥ 3 pads/day was the only independent predictor of SI at 6, 9, and 12 months postoperative (Table 1). Conclusions Approximately one-quarter of our cohort experienced SI within 12 months after RP. SI was more prevalent among patients with severe SUI, particularly at the 6-month mark and beyond after RP during the first-year post-surgery. Severe SUI significantly predicted SI during the first year following surgery. Disclosure No.