PROSPECTIVE ASSESSMENT OF PATIENT REPORTED URINARY CONTINENCE AFTER RADICAL PROSTATECTOMY

Abstract

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Sep 2000PROSPECTIVE ASSESSMENT OF PATIENT REPORTED URINARY CONTINENCE AFTER RADICAL PROSTATECTOMY JOHN T. WEI, RODNEY L. DUNN, ROBERT MARCOVICH, JAMES E. MONTIE, and MARTIN G. SANDA JOHN T. WEIJOHN T. WEI More articles by this author , RODNEY L. DUNNRODNEY L. DUNN More articles by this author , ROBERT MARCOVICHROBERT MARCOVICH More articles by this author , JAMES E. MONTIEJAMES E. MONTIE More articles by this author , and MARTIN G. SANDAMARTIN G. SANDA More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)67294-1AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Reported urinary continence rates after radical prostatectomy vary. Although modifications of radical prostatectomy meant to improve outcome, such as nerve sparing or bladder neck preservation, are in widespread use, to our knowledge evidence to support these practices based on patient report is scant. We evaluated the potential effects of nerve sparing and bladder neck preservation on urinary continence after radical prostatectomy, and assessed the impact of various urinary continence definitions on the observed outcome. Materials and Methods: We prospectively evaluated a cohort of men with prostate cancer who elected surgery with and without nerve sparing, and bladder neck preservation as primary therapy. A total of 482 men completed a brief urinary continence questionnaire preoperatively and postoperatively at a median followup of 18 months. Urinary continence was followed prospectively using the questionnaire and patient reported urinary continence recovery was based on 3 definitions of continence. Results: Median time to continence recovery based on patient reporting was significantly shorter in the nerve sparing than in the nonnerve sparing group when continence was defined as no urinary leakage (5.3 versus 10.9 months, p <0.01). A multivariate model controlling for baseline factors revealed that significant predictors of continence outcome were preoperative continence, patient age, nerve sparing and the interaction of nerve sparing with age (p <0.05). The definition of urinary continence also affected outcome. Conclusions: The nerve sparing technique of radical prostatectomy was associated with improved recovery of urinary continence in an age dependent manner, whereas bladder neck preservation was not beneficial. Patient age and the sensitivity of the incontinence definitions, as reflected by the associated variable rates of preoperative baseline incontinence, are significant contexts for interpreting urinary function data after radical prostatectomy. 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(2018) EDITORIAL COMMENTJournal of Urology, VOL. 166, NO. 4, (1337-1338), Online publication date: 1-Oct-2001.KIELB S, DUNN R, RASHID M, MURRAY S, SANDA M, MONTIE J and WEI J (2018) ASSESSMENT OF EARLY CONTINENCE RECOVERY AFTER RADICAL PROSTATECTOMY: PATIENT REPORTED SYMPTOMS AND IMPAIRMENTJournal of Urology, VOL. 166, NO. 3, (958-961), Online publication date: 1-Sep-2001. Volume 164Issue 3 Part 1September 2000Page: 744-748 Advertisement Copyright & Permissions© 2000 by American Urological Association, Inc.Keywordsoutcome assessment (health care)quality of lifeurinary incontinenceprostatectomyprostateMetricsAuthor Information JOHN T. WEI More articles by this author RODNEY L. DUNN More articles by this author ROBERT MARCOVICH More articles by this author JAMES E. MONTIE More articles by this author MARTIN G. SANDA More articles by this author Expand All Advertisement PDF downloadLoading ...