MP38-19 THE UTILIZATION OF INCONTINENCE PROCEDURES VARIES BY RACE IN PROSTATE CANCER SURVIVORS

Abstract

INTRODUCTION AND OBJECTIVES: Voiding dysfunction and urinary incontinence after radical prostatectomy has been reported to range from 3% to as high as 90%. In addition, little is known about racial differences in post prostatectomy incontinence and the utilization of anti-incontinence procedures. We analyzed the rates of anti-incontinence procedures after radical prostatectomy with respect to race at a single institute. METHODS: We conducted an IRB approved retrospective review of the billing data of patients with prostate cancer who underwent radical prostatectomy (open, laparoscopic, or robotic) at a single institute over a 10-year period. Demographic data including race and ethnicity, marital status, age at treatment and surgical therapy for urinary incontinence with either a male sling or artificial urinary sphincter (AUS) were reviewed. RESULTS: 4401 men underwent radical prostatectomy over the study period. 30% of the patients underwent laparoscopic or robotic prostatectomy, 8.5% underwent perineal prostatectomy, and 60% underwent retropubic radical prostatectomy. 74.3% of the patients were Caucasian (mean age of 62.7 years at treatment), and 22.1% were African American (mean age of 60 years at treatment). 165 (3.7%) patients underwent a total of 191 procedures for male urethral sling or artificial urinary sphincter placement. Among men who underwent incontinence surgery, the mean age at radical prostatectomy was 63 years, and the median time from prostatectomy to first incontinence surgery was 20 months. The first incontinence procedure was a male sling in 63% and AUS in 37% of patients. White Caucasian men had a higher rate of anti-incontinence procedure utilization compared to African American men (4.3% versus 2.1%, p 1⁄40.001) and had a shorter time to incontinence surgery after prostatectomy (19.8 months versus 28.3 months, p <0.05). There was no racial difference in the types of incontinence procedure performed (sling versus AUS). There was no difference noted in incontinence procedure utilization based on ethnicity, marital status, or religion. CONCLUSIONS: The overall rate of incontinence surgery after radical prostatectomy at our institute is 3.7%. African American men receive antiincontinence procedures at a lower rate and with a longer delay after prostatectomy than Caucasian men. Further studies are needed to define the potential reasons for this racial disparity in urinary incontinence surgery in the prostate cancer survivor.