MP88-04 URINARY INCONTINENCE AND SATISFACTION WITH TREATMENTS AFTER ROBOTIC ASSISTED RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Male Incontinence: Therapy1 Apr 2015MP88-04 URINARY INCONTINENCE AND SATISFACTION WITH TREATMENTS AFTER ROBOTIC ASSISTED RADICAL PROSTATECTOMY Avinash Chennamsetty, Hafron Jason, Behdod Poushanchi, Scott Pew, Jay Hollander, Kim Killinger, Mary Coffey, and Kenneth Peters Avinash ChennamsettyAvinash Chennamsetty More articles by this author , Hafron JasonHafron Jason More articles by this author , Behdod PoushanchiBehdod Poushanchi More articles by this author , Scott PewScott Pew More articles by this author , Jay HollanderJay Hollander More articles by this author , Kim KillingerKim Killinger More articles by this author , Mary CoffeyMary Coffey More articles by this author , and Kenneth PetersKenneth Peters More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1837AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Long term urinary incontinence (UI) and treatment satisfaction after robotic assisted radical prostatectomy (RARP) is not well known. We sought to evaluate urinary incontinence, treatments used, and treatment satisfaction in a cohort of patients that had robotic prostatectomy over a 10 year period. METHODS Surveys were mailed to 1,587 men who underwent RARP between 2003 and 2012. Using the Expanded Prostate Cancer Index−26 short form, men recalled preoperative UI and reported current continence. Those leaking more than rarely/never were considered incontinent. RESULTS In 588 men (mean age 61.5 ± 6.6 years), 79% had stage T2 prostate cancer. Prior to RARP, 94% were dry. At time of survey (mean 5.1 ± 2.6 years since RARP), 50% (268/541) of men dry before RARP were continent. However, 20% (54/272) reported UI was a moderate or big problem. 27% (157/580) reported having used treatments for UI. Satisfied/extremely satisfied with each treatment were 84/126 (67%) for pads, 5/21 (24%) for medications, 11/17 (65%) for pelvic floor physical therapy, and 6/16 (38%) for male sling. 9 used a penile clamp (3 satisfied), 6 used a condom catheter (4 satisfied), 6 had an artificial urinary sphincter (1 satisfied), and 3 underwent neuromodulation (0 satisfied). Incontinent/continent men were also compared on various factors that might place them at increased risk for UI. Although both groups were overweight (BMI >25), the incontinent group had a significantly higher BMI (p=0.008). ASA scores were also overall slightly higher (p=0.04) in the incontinent group. CONCLUSIONS Many men still experience UI even years after RARP, relatively few obtain treatment, and satisfaction with individual treatments is relatively low. Ongoing assessment and discussions of treatment options are needed. Incontinent N = 273 Continent N = 268 P-value Age (yr) Mean ± SD 61.9 ± 6.6 60.8 ± 6.6 .053 BMI Median 28.3 38.0 .008 Prostate Wt. (gm) Median 38.0 38.0 .53 Prior Prostate Surgery 12/273 (4%) 9/264 (3%) .67 Pathological Stage .34 T2 209/271 (77%) 212/263 (81%) T3 62/271 (23%) 51/263 (19%) Diabetes 32/272 (12%) 24/263 (9%) .33 ASA Score .04 1 8/260 (3%) 18/261 (7%) 2 190/260 (73%) 195/261 (75%) 3 62/260 (24%) 46/261 (18%) 4 0/260 (0%) 2/261 (1%) Years since RARP 0.39 ≤ 2 yrs 39/273 (14%) 50/267 (19%) 2 to 5 yrs 92/273 (34%) 86/267 (32%) ≥ 5 yrs 142/273 (52%) 131/267 (49%) New Urinary Incontinence after Robotic Assisted Radical Prostatectomy Incontinent N = 273 Continent N = 268 Overall Urinary Function/Bother N (%) N = 272 N = 266 No Problem 69 (25.4) 228 (85.7) Very Small Problem 94 (34.6) 25 (9.4) Small Problem 55 (20.2) 9 (3.4) Moderate Problem 33 (12.1) 4 (1.5) Big Problem 21 (7.72) 0 © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1093 Peer Review Report Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Avinash Chennamsetty More articles by this author Hafron Jason More articles by this author Behdod Poushanchi More articles by this author Scott Pew More articles by this author Jay Hollander More articles by this author Kim Killinger More articles by this author Mary Coffey More articles by this author Kenneth Peters More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...